Rare Case of Large Bowel Obstruction due to Plasmacytoid Urothelial Carcinoma Highlights Importance of Alternative Diagnosis and Subsequent Management

Strategic Insights -

A new study published in Surgical Case Reports has highlighted a rare case of large bowel obstruction caused by plasmacytoid urothelial carcinoma (PUC), a subtype of bladder cancer. The research, conducted by investigators at the Kanto Central Hospital of the Mutual Aid Association of Public School Teachers in Tokyo, Japan, sheds light on the importance of considering alternative differential diagnoses and planning appropriate subsequent management in cases where colorectal cancer is not the primary cause of large bowel obstruction.

Key Takeaways:

  • Plasmacytoid urothelial carcinoma is a rare subtype of bladder cancer that can present aggressively and metastasize, including to the peritoneum, which may lead to large bowel obstruction.
  • The study reports a case of a 68-year-old woman who presented with hematochezia and abdominal pain due to PUC, which initially presented a diagnostic challenge and required laparoscopy to establish a diagnosis.
  • The patient underwent ileo-transverse colon bypass and excisional biopsy, which led to the diagnosis of PUC, but unfortunately, the patient died 69 days after the operation due to complications.
  • The study emphasizes the importance of considering alternative differential diagnoses and planning appropriate subsequent management in cases where colorectal cancer is not the primary cause of large bowel obstruction.
  • The authors highlight the role of pembrolizumab in the treatment of PUC, but note that the patient experienced complications and died despite best supportive care.
  • The study reports a single case of large bowel obstruction due to PUC, which is a rare subtype of bladder cancer.
  • The patient was a 68-year-old woman who presented with hematochezia and abdominal pain.
  • The patient had a history of recurrent bladder cancer treated with chemotherapy and multiple transurethral resections of bladder tumor (TURBT).
  • The study highlights the importance of considering alternative differential diagnoses and planning appropriate subsequent management in cases where colorectal cancer is not the primary cause of large bowel obstruction.

Statistics:

  • The patient was a 68-year-old woman who presented with hematochezia and abdominal pain.
  • The patient had a history of recurrent bladder cancer treated with chemotherapy and multiple TURBT.
  • The patient underwent ileo-transverse colon bypass and excisional biopsy.
  • The patient died 69 days after the operation due to complications.
  • Pembrolizumab was administered in 2 courses, but the patient experienced pulmonary edema with pneumonia and died despite best supportive care.

Sources:

  • Surgical Case Reports. "Rare Case of Large Bowel Obstruction due to Plasmacytoid Urothelial Carcinoma." Vol. 11, No. 1, 2025.
  • NewsRx. "Studies from Kanto Central Hospital of the Mutual Aid Association of Public School Teachers Provide New Data on Urothelial Cancer (Rare Case of Large Bowel Obstruction due to Plasmacytoid Urothelial Carcinoma)." Cancer Weekly, September 16, 2025; p 7472.