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  3. [a Case Of Acute Exacerbation Of Interstitial Pneumonia After Robot-assisted Total Cystectomy].
  1. Home
  3. [a Case Of Acute Exacerbation Of Interstitial Pneumonia After Robot-assisted Total Cystectomy].

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[A CASE OF ACUTE EXACERBATION OF INTERSTITIAL PNEUMONIA AFTER ROBOT-ASSISTED TOTAL CYSTECTOMY].

Yasuhiro Numata1, Hiroki Ito1, Tomoyuki Tatenuma1

  • 1The Department of Urology, Yokohama City University Hospital.

Nihon Hinyokika Gakkai Zasshi. the Japanese Journal of Urology
|January 21, 2026

View abstract on PubMed

Summary
This summary is machine-generated.

This case study details a bladder cancer patient who developed acute exacerbation of interstitial pneumonia (IP) post-surgery. Prompt steroid therapy and oxygen support led to recovery, with no tumor recurrence observed.

Keywords:
Interstitial pneumoniaRobot-assisted radical cystectomy (RARC)

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Area of Science:

  • Oncology
  • Pulmonology
  • Medical Imaging

Background:

  • A 79-year-old male diagnosed with urothelial carcinoma with squamous differentiation (pT2N0M0) presented with hydronephrosis and lung abnormalities.
  • The patient received neoadjuvant chemotherapy (gemcitabine and cisplatin) followed by robot-assisted radical cystectomy and cutaneous ureterostomy.

Purpose of the Study:

  • To report a case of acute exacerbation of interstitial pneumonia (IP) following radical cystectomy for bladder cancer.
  • To highlight the successful management of postoperative IP with steroid pulse therapy and high-flow oxygenation.

Main Methods:

  • Computed tomography (CT) scans were used for initial diagnosis and monitoring.
  • Treatment involved neoadjuvant chemotherapy, robot-assisted radical cystectomy, and subsequent management of acute exacerbation of interstitial pneumonia (IP) with methylprednisolone (mPSL) pulse therapy and nasal high-flow (NHF) oxygen.
  • Postoperative follow-up included imaging to assess for tumor recurrence and IP progression.

    • Main Results:

    • The patient developed acute exacerbation of interstitial pneumonia (IP) on postoperative day 2, characterized by decreased SpO2 and diffuse reticular shadows on CT.
    • Immediate initiation of methylprednisolone (mPSL) pulse therapy and nasal high-flow (NHF) oxygen resulted in a positive clinical response.
    • The patient was successfully weaned from NHF oxygen on postoperative day 9 and discharged with home oxygen therapy, with no worsening of IP.
    • Six-month follow-up CT scans showed no evidence of tumor recurrence or progression.

    Conclusions:

    • Acute exacerbation of interstitial pneumonia (IP) is a potential complication after radical cystectomy.
    • Early diagnosis and prompt treatment with systemic corticosteroids and respiratory support are crucial for managing this condition.
    • This case demonstrates the efficacy of methylprednisolone (mPSL) pulse therapy and nasal high-flow (NHF) oxygen in resolving postoperative IP, allowing for successful patient discharge and continued oncological surveillance.