Unusual Presentation of Advanced Urothelial Cancer in a Young Patient.

Nara Shin, Cora N Sternberg, Olivier Elemento, Daniela Guevara, Alexandra Boiko, Ivan Valiev, Ahmed G Elsaeed, Juan Miguel Mosquera, Majd Al Assaad, Jyothi Manohar, Michael Sigouros, Alisa Zaichikova, Victoria Fomchenkova, Leysan Yunusova, Sofia Smirnova, David Nanus

Journal: Anticancer research 2025;45(2):613-618

PMID: 39890191

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Abstract

BACKGROUND/AIM

Urothelial carcinoma, common in older adults, is rare in younger populations and even less common in the prostatic urethra. Advanced disease is typically managed with platinum-based chemotherapy, immune checkpoint inhibitors, and targeted therapies. However, rare presentations in young patients with aggressive disease highlight the need for innovative and personalized treatment strategies.

CASE REPORT

This case report presents a rare instance of metastatic urothelial carcinoma originating in the prostatic urethra of a 37-year-old male. Initial symptoms led to diagnosis through imaging, biopsy, and genetic profiling, revealing mutations in TP53 and RB1. The patient underwent multiple treatments, including dose-dense chemotherapy, pembrolizumab immunotherapy, and targeted antibody-drug conjugates (Enfortumab Vedotin and Sacituzumab Govitecan). Despite aggressive therapies, disease management remained challenging, leading to experimental treatments, including a personalized vaccine.

CONCLUSION

This case underscores the importance of precision medicine and the need for innovative treatment options for rare and aggressive cancers.

Address: Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, NY, U.S.A.; BostonGene Corporation, Waltham, MA, U.S.A.; Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, NY, U.S.A.; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, U.S.A.; Department of Medicine, Weill Cornell Medicine, New York, NY, U.S.A.; Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, NY, U.S.A. [email protected].; Department of Medicine, Weill Cornell Medicine, New York, NY, U.S.A.

DOI: 10.21873/anticanres.17448