[Metastatic micropapillary variant of urothelial carcinoma of the urinary bladder responding to gemcitabine and cisplatin chemotherapy].

A 69-year-old man was admitted to our hospital with a chief complaint of lymphatic edema of left arm. He had a past history of transurethral resection of the bladder tumor 5 years ago, and pathological diagnosis was urothelial carcinoma with micropapillary variant, G3 = G2, pT1. CT scan revealed bladder tumor with invasion of the rectum, and multiple lymph nodes swelling in the axilla, retroperitoneum and pelvis (cT4bN3M1). The patient underwent biopsies of the bladder wall and the left axillary lymph nodes, and pathologic examination revealed micropapillary carcinoma. Five courses of gemcitabine plus cisplatin (GC therapy) were perfomed, and bladder tumor and lymph node metastases reduced remarkably, with serum CA19-9 level decreasing from 172,000 U/ml to 106 U/ml. However, the patient died from recurrence 23 months after the start of GC therapy.