79-year-old female patient with terminal chronic renal failure secondary to diabetic nephropathy, on hemodialysis program for four years, and a history of allergy to penicillin-confirmed, which refers diffuse abdominal discomfort in the parietal mesogastric pathology,
1.
Physical examination only revealed discomforts coinciding with bimanual a non-vaginal discomfort, as well as some decrease in bladder mobility.
Basic laboratory parameters were within normal limits, except for blood glucose 146 mg/dL, serum creatinine 9.5 mg/dL and mild leukocytosis and neutrophilia, 11,600 leucocytes/ mL with 74 % neutrophils.
Cystoscopy was indicated, confirming the existence of a diffuse parietal thickening, affecting especially the base and both sides of the bladder, with some areas of greater protrusion.
Cold biopsy was taken, whose study allowed to objectify a significant inflammatory infiltrate with eosinophilic component.
1.
Due to the persistence of the patient's symptoms, transurethral resection of the affected areas was chosen.
The anatomopathological study showed the existence of a transitional carcinoma of high grade with depth bladder wall.
Given the patient's conditioning factors, as well as an unsatisfactory baseline status, it was agreed with her family not to submit her to aggressive exercise surgeries, and she was given pelvic radiotherapy.
1.
Two months after surgery, multiple bilateral lung metastases were detected in non-pelvic TAC.
The subsequent deterioration of the patient was progressive, producing the death three months after this test.
