case_images: PMC11178393_01
case_images: CT findings before treatments showed an invasive bladder tumor with (a) bilateral hydroureters (arrows) and (b) osteolytic metastasis (arrow). Pathological findings of needle biopsy of bladder and prostate lesions revealed luminal-type urothelial carcinoma ((c) hematoxylin and eosin), (d) androgen receptor-negative, (e) GATA3-positive, (f) CK20-positive, and (g) PD-L1 negative. There were almost no tumor-infiltrating lymphocytes within the tumor tissue ((g) circles). Internal control histiocytes are PD-L1 positive ((g) arrow).
case_images: CRIU2024-7525757.001.jpg
case_images: PMC11178393_01_CRIU2024-7525757.001.jpg
case_images: fig1
case_images: Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a bladder tumor invading the prostate and penile base, and multiple bone metastases with pelvic and vertebral bones (Th3 and Th12-L5) (Figure 1). The pathological findings revealed urothelial carcinoma (Figure 1).
case_images: CT findings four weeks after starting pembrolizumab therapy revealed a significant reduction in the size of the primary lesion (a), as well as a decrease in osteolytic lesions at the bone metastatic sites with a shift towards osteoblastic change (b, arrow).
case_images: CRIU2024-7525757.002.jpg
case_images: PMC11178393_01_CRIU2024-7525757.002.jpg
case_images: fig2
case_images: CT scan was conducted four weeks after starting pembrolizumab therapy to assess the early treatment response. CT showed that both the primary and metastatic lesions had notably reduced in size, and no new lesion was detected (Figure 2).
case_images: Pathological findings of fracture lesion revealed no residual cancer tissue with osteoblastic change.
case_images: CRIU2024-7525757.003.jpg
case_images: PMC11178393_01_CRIU2024-7525757.003.jpg
case_images: fig3
case_images: Pathological examination of the fracture site revealed no residual tumor tissue (Figure 3).