Abstract:

This article reports a case of pelvic recurrence after radical cystectomy for bladder cancer.The patient was admitted to the hospital due to "progressive increase of pelvic mass for 2 years after radical cystectomy for bladder cancer 9 years".PET-CT showed a cystic and solid mass on the right side of the pelvis after radical cystectomy， which was considered a malignant lesion， possibly from the intestinal substitute bladder or recurrence of bladder cancer.The lesion involved the right iliac vessels， the right obturator internus muscle， and the left ureteral stoma， accompanied by hydronephrosis of the left kidney and hydroureter of the left ureter.The local lesion was indistinguishable from the adjacent sigmoid colon and small intestine， and there was a presacral nodule with abnormally increased glucose metabolism， suggesting metastasis.After multidisciplinary consultation on difficult cases in Guangdong Urological Association， experts considered that the surgery was difficult and recommended taking a biopsy first to confirm the pathology and then give chemotherapy.The surgery would be re-evaluated based on the therapeutic effect.Subsequently， a biopsy of the pelvic mass was performed under ultrasound guidance， and the pathological result indicated metastatic urothelial carcinoma.The patient was treated with GC chemotherapy （gemcitabine 1 600 mg + lobaplatin 45 mg）.The patient underwent a follow-up CT scan after over a month of chemotherapy， which showed no significant changes in tumor size compared to previous imaging.Experts recommend continuing chemotherapy or participating in clinical drug trials.The patient is currently continuing chemotherapy， and the next treatment plan will be reassessed after monitoring the therapeutic effects.The prognosis of pelvic recurrence after bladder cancer surgery is poor， with severe tumor adhesion， high surgical difficulty and risk.Ultrasound-guided biopsy has advantages.Treatment should be individualized， providing radiotherapy， chemotherapy， surgery or combined treatment.

Key words: Bladder cancer, Recurrence of tumor, Pelvic tumor, Multidisciplinary treatment, Individual treatment