A Case of Bladder Cancer in a Patient with Systemic Lupus Erythematosus Treated with Oral Cyclophosphamide.
- Author:
Ki Jo KIM
1
;
Woo Tae KIM
;
Sung Yong KIM
;
Ji Hyun HONG
;
Hae Rim KIM
;
Chong Hyeon YOON
;
Sang Heon LEE
;
Sung Hwan PARK
;
Ho Youn KIM
Author Information
1. Division of Rheumatology, Department of Internal Medicine, Kangnam St Mary's Hospital, College of Medicine, The Catholic University of Korea, Korea. rapark@catholic.ac.kr
- Publication Type:Case Report
- Keywords:
Cyclophosphamide;
Systemic lupus erythematosus;
Bladder cancer
- MeSH:
Acrolein;
Arthritis, Rheumatoid;
Cyclophosphamide*;
Cystitis;
Fibrosis;
Humans;
Liver;
Lupus Erythematosus, Systemic*;
Mechlorethamine;
Nephrotic Syndrome;
Organ Transplantation;
Transplants;
Urinary Bladder Neoplasms*;
Urinary Bladder*;
Urothelium;
Wegener Granulomatosis
- From:The Journal of the Korean Rheumatism Association
2004;11(3):286-291
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Cyclophosphamide, a cytotoxic alkylating agent, is widely used in various benign diseases like systemic lupus erythematosus (SLE), Wegener's granulomatosis, rheumatoid arthritis, nephrotic syndrome as well as in malignancies and organ transplantation. Cyclophosphamide is metabolized in the liver to various chlormethine metabolites and acrolein, which mediates the toxic effect to the urothelium and can cause hemorrhagic cystitis, bladder fibrosis, and has also been associated with urothelial malignancies including bladder cancer. It is known that SLE is not associated with an increased risk for the development of most of the solid tumors. But it has been suggested that the risk of the bladder cancer increases in patients with benign diseases such as SLE treated by cyclophosphamide. There are only very few reports of cyclophosphamide-induced bladder cancer in SLE so far. We report a case of a patient who developed bladder cancer 13 years after cyclophosphamide was given as therapy for SLE. This case shows that careful observation and urologic evaluation is undoubtedly important for patients treated with cyclophosphamide.
