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Unusual complication after immediate postoperative intravesical mitomycin C instillation
Jakko A Nieuwenhuijzen1, Axel Bex, Simon Horenblas
1Department of Urology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands. j.nieuwenhuijzen@nki.nl
European Urology
|May 28, 2003
Summary
Immediate adjuvant Mitomycin C (MMC) instillation for superficial bladder cancer can cause severe pelvic pain due to extravasation. This case highlights the need for accurate diagnosis, with MRI proving superior to CT for assessing soft tissue injury and guiding treatment.
Area of Science:
- Urology
- Oncology
- Radiology
Background:
- Intravesical Mitomycin C (MMC) instillation is a standard adjuvant therapy for non-muscle-invasive bladder cancer.
- While generally safe, complications such as extravasation can occur, necessitating prompt recognition and management.
Observation:
- A patient experienced severe, persistent pelvic pain following intravesical MMC instillation for superficial bladder cancer.
- The extravasation injury did not resolve spontaneously and required surgical intervention.
Findings:
- Magnetic Resonance Imaging (MRI) demonstrated superior accuracy compared to Computed Tomography (CT) in evaluating the extent of perivesical soft tissue injury from MMC extravasation.
- The case underscores the potential for significant morbidity from this complication.
Implications:
- This case highlights the importance of considering and diagnosing MMC extravasation in patients presenting with severe pelvic pain post-instillation.
- Accurate radiological assessment, preferably with MRI, is crucial for surgical planning and management.
- Strategies for prevention, diagnosis, and treatment of symptomatic MMC extravasation should be refined.