-Case Reports-

Early and Post-Treatment Imaging Findings in Perineural Spread: A Pathway to Diffuse Muscle Metastasis in Recurrent Bladder Carcinoma

Yoshimitsu Honda^1,2, Tetsuro Sekine², Ryoji Kimata³, Norio Motoda⁴, Keigo Takahashi³, Aya Yamane², Daisuke Yasui², Eigo Kodani², Taro Ichikawa² and Shinichiro Kumita¹

¹Department of Radiology, Nippon Medical School, Tokyo, Japan
²Department of Radiology, Nippon Medical School Musashi Kosugi Hospital, Kanagawa, Japan
³Department of Urology, Nippon Medical School Musashi Kosugi Hospital, Kanagawa, Japan
⁴Department of Diagnostic Pathology, Nippon Medical School Musashi Kosugi Hospital, Kanagawa, Japan

Perineural spread (PNS) from pelvic carcinoma has been regarded as a pathway to muscle and bone metastasis. However, few cases have been reported, especially in patients with bladder carcinoma. In the present report, we discuss a case of diffuse cancer involvement in the muscle 5 years after radical cystectomy for advanced bladder carcinoma. Careful observation of temporal changes on medical images confirmed PNS as the pathway to muscle metastasis (i.e., primary PNS). Our report presents early and post-treatment CT, MRI and FDG-PET/CT findings of PNS from the bladder carcinoma.

J Nippon Med Sch 2024; 91: 333-338

Keywords
muscle metastasis, bladder carcinoma, perineural spread, PET/CT, MRI

Correspondence to
Tetsuro Sekine, Department of Radiology, Nippon Medical School Musashi Kosugi Hospital, 1-383 Kosugi-cho, Nakahara-ku, Kawasaki, Kanagawa 211-8533, Japan
tetsuro.sekine@gmail.com

Received, October 19, 2022
Accepted, December 28, 2022