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Osteoclastic Giant Cell Variant of Urothelial Carcinoma in a COVID-Positive Patient:

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by

Vishnu
in

Introduction: Bladder cancer presents various histological variants, with osteoclastic giant cell (OGC) urothelial carcinoma being one of the rarest. This case report explores the occurrence of OGC in a COVID-19-positive patient, emphasizing its diagnostic challenges and clinical significance. Visit https://www.clinmedcasereportsjournal.org/acr for more groundbreaking research in this field.

Understanding Osteoclastic Giant Cell Variant of Urothelial Carcinoma

  • Urothelial carcinoma is the most common type of bladder cancer, with over 90% arising from transitional epithelium.
  • The OGC variant is an extremely rare subtype, first identified in 2006, with fewer than 30 documented cases worldwide.
  • This variant is known for its aggressive nature and association with poor prognosis.

Case Summary:

  • A 63-year-old male with hypertension and hypertrophic cardiomyopathy presented with intermittent gross hematuria.
  • Imaging revealed a soft tissue mass in the urinary bladder, leading to a transurethral resection of bladder tumor (TURBT).
  • Histopathology confirmed high-grade urothelial carcinoma with osteoclastic giant cells, positive for CD68 and negative for CK20 and desmin.
  • The patient was scheduled for chemotherapy but tested positive for COVID-19, requiring a delay in treatment.

Implications of COVID-19 in Cancer Patients Studies indicate that COVID-19 significantly affects cancer patients, increasing disease severity and mortality risk. The American Cancer Society (ACS) highlights that cancer patients undergoing treatment may experience heightened immunosuppression, making them more vulnerable to infections, including COVID-19.

Management Challenges and Treatment Considerations

  • Standard treatment for muscle-invasive bladder cancer includes neoadjuvant chemotherapy followed by radical cystectomy.
  • The ongoing pandemic has led to revised guidelines for cancer management, advocating for risk-benefit assessment before proceeding with immunosuppressive treatments.
  • In this case, chemotherapy was delayed due to COVID-19 positivity, but the patient recovered and resumed follow-up care.

Further Reading and References

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