Schistosomiasis and Urothelial Bladder Carcinoma

Rodrigo de Carvalho Holanda Leite¹, Cecília Maria de Carvalho Xavier Holanda^2*, Paulo José de Medeiros^3,4

¹Onofre Lopes University Hospital (HUOL), Natal, Brazil.
²Department of Microbiology and Parasitology, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil.
³Department of Integrated Medicine, Onofre Lopes University Hospital (HUOL), Natal, Brazil.
⁴Department of Integrated Medicine, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil.

DOI: 10.4236/crcm.2014.39116                

Abstract

Bladder cancer is the most common malignancy of the urinary tract and it affects four times more men than women. The relationship between bladder tumors and Schistosoma haematobium is well known, but only sporadic cases of bladder infection due to Schistosoma mansoni have been reported. Schistosoma mansoni infection causes an endemic disease in Brazil (schistosomiasis) and gastrointestinal disorders are very common, but disease of the urinary tract is atypical. The aim of this study was to describe a case of a patient presenting schistosomiasis (S. mansoni) and urothelial bladder carcinoma. In this case, a 37-year-old man with intermittent painless gross hematuria was investigated. Cystoscopy revealed a small pedunculated lesion in the bladder dome. Transurethral resection revealed urothelial carcinoma of the bladder, low degree, unrepresentative of the muscular layer of the bladder. After 30 days, a new transurethral resection was performed to sample acquisition of the muscular layer on the basis of the scar. Histopathology was negative for malignancy (Tumor Node Metastasis: TNM-T1). During this procedure, there was evidence of dark rounded lesion in the bladder dome. It was excised and the histopathology showed viable eggs of Schistosoma mansoni. The patient was treated orally with oxamniquine and remained in oncological monitoring with cystoscopy quarterly and serial clinical evaluation. This case reveals a rare finding of Schistosoma mansoni in the bladder and urothelial bladder carcinoma coexisting in the same patient.

Keywords

Schistosoma mansoni, Bladder Cancer, Schistosomiasis, Oxamniquine

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Jamal, A., Bray, F., Center, M.M., Ferlay, J., Ward, E. and Forman, D. (2011) Global Cancer Statistics. Cancer Journal for Clinicians, 61, 69-90. http://dx.doi.org/10.3322/caac.20107
[2]	Jankovic, S. and Radosavljevic, V. (2007) Risk Factors for Bladder Cancer. Tumors, 93, 4-12.
[3]	Wilkins, H.A. (1977) Schistosoma haematobium in a Gambian Community—The Prevalence of Bacteriuria and Hypertension. Annals of Tropical Medicine and Parasitology, 71, 179-186.
[4]	Badawi, A.F. and Mostafa M.H. (1993) Possible Mechanisms of Alteration in the Capacities of Carcinogen Metabolising Enzymes during Schistosomiasis and Their Role in Bladder Cancer Induction. Journal of International Medical Research, 21, 281-305.
[5]	Lopes, E.J.A., de Almeida, C.E.R. and Jacobino, M. (2007) Schistosomiasis Mansoni in the Seminal Vesicle. Revista da Sociedade Brasileira de Medicina Tropical, 40, 341-342. http://dx.doi.org/10.1590/S0037-86822007000300018
[6]	Tamimi, Y., Bringuier, P.P., Smit, F., Bokhoven, A., Abbas, A., Debruyne, F.M. and Schalken, J.A. (1996) Homozygous Deletions of p16INK4 Occur Frequency in Bilharziasis—Associated Bladder Cancer. International Journal of Cancer, 68, 183-187. http://dx.doi.org/10.1002/(SICI)1097-0215(19961009)68:2<183::AID-IJC7>3.0.CO;2-U
[7]	Pelucchi, C., Bosetti, C., Negri, E., Malvezzi, M. and La, V.C. (2006) Mechanisms of Disease—The Epidemiology of Bladder Cancer. Nature Clinical Practice Urology, 3, 327-340. http://dx.doi.org/10.1038/ncpuro0510
[8]	Gryseels, B., Polman, K., Clerinx, J. and Kestens, L. (2006) Human Schistosomiasis. Lancet, 368, 1106-1118. http://dx.doi.org/10.1016/S0140-6736(06)69440-3
[9]	Yosry, A. (2006) Schistosomiasis and Neoplasia. Contributions to Microbiology, 13, 81-100. http://dx.doi.org/10.1159/000092967
[10]	Rosin, M.P., Anwar, W.A. and Ward, A.J. (1994) Inflammation, Chromosomal Instability and Cancer—The Schistosomiasis Model. Cancer Research, 54, 1929-1933.
[11]	Margison, G.P. and O’Connor, P.J. (1990) Biological Consequences of Reactions with DNA. Role of Specific Lesions. Carcinogenesis and Mutagenesis. In: Grover, P.L. and Cooper, C.S., Eds., Handbook of Experimental Pharmacology, Heidelberg K.G., Springer-Verlag, Germany, Vol. 94, 547-571.
[12]	Nurse, P. (1997) Regulation of the Eukaryotic Cell Cycle. European Journal of Cancer, 33, 1002-1004. http://dx.doi.org/10.1016/S0959-8049(97)00091-9
[13]	Sherif, M., El-Bolkany, N. and Badawi, A. (1975) Clinical Staging of Malignant Lymphoma in Patients Suspected to Have Hepato-Splenic Schistosomiasis. Journal of Tropical Medicine Hygiene, 78, 67-70.
[14]	Lopes, E.J., Santos, T.C. and Martins, V. (2006) Esquistossomose Mansônica Simulando Neoplasia da Bexiga. Revista da Sociedade Brasileira de Medicina Tropical, 39, 287-288. http://dx.doi.org/10.1590/S0037-86822006000300013
[15]	Meira, J.A. (1944) Esquistossomose Mansônica com Localização Vesical. Seara Médica, 3, 61.
[16]	Sayão, R.H., Cury, J., Carneiro-Neto, J. and Sayão, M.H. (1977) Esquistossomose Mansônica Vesical. Journal of the Brazilian Society of Urology, 3, 114-116.
[17]	Mitre, A., Alfer Jr., W., Nahas, W. and Arap, S. (1980) Esquistossomose Mansônica Vesical Simulando Tumor—Relato de Um Caso. Revista da Associação Médica Brasileira, 26, 74-76.