A 65-Year-Old Female With Urothelial Carcinoma

Case: A 65-Year-Old Female With Urothelial Carcinoma

Initial presentation

• A 65-year-old female presents with 2 weeks of intermittent gross hematuria
• PMH: COPD, HTN
• SH: 30-pack year smoking history

Clinical workup

• Labs: Hb 10.2 g/dl, WBC 2.8 x 109/L, creatinine 1.3 mg/dL, creatinine clearance 68 ml/min; other WNL
• TURBT large bladder mass, high grade muscle invasive urothelial cancer
• CT scan of the abdomen and pelvis: large bladder mass, pelvic and para aortic adenopathy (largest 2.2 cm); CT Chest 3 sub cm nodules uncertain significance
• Stage T3N2M1

Treatment

• The patient received cisplatin + gemcitabine for 6 cycles; stable disease
• Repeat imaging CT chest 2 of the sub cm lesions no longer appreciated
• CT abd/pelvis decrease size in bladder mass, nodal findings mildly improved, no new disease
• Avelumab 10 mg/kg IV q2W was started as maintenance therapy