Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 6, 2023; 11(16): 3921-3928
Published online Jun 6, 2023. doi: 10.12998/wjcc.v11.i16.3921
Coexistence of urinary tuberculosis and urothelial carcinoma: A case report
Yu-Chi Tsai, Chiao-Ching Li, Bing-Tau Chen, Chien-Yao Wang
Yu-Chi Tsai, Chien-Yao Wang, Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung 802301, Taiwan
Yu-Chi Tsai, Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114202, Taiwan
Chiao-Ching Li, Division of Urology, Department of Surgery, Pingtung branch, Kaohsiung Armed Forces General Hospital, Pingtung 900048, Taiwan
Chiao-Ching Li, Bing-Tau Chen, Division of Urology, Department of Surgery, Kaohsiung Armed Forces General Hospital, Kaohsiung 802301, Taiwan
Chiao-Ching Li, Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114202, Taiwan
Bing-Tau Chen, Division of Urology, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan
Author contributions: Tsai YC and Wang CY designed this study; Li CC and Chen BT participated in the surgery; Tsai YC, Li CC, Chen BT, and Wang CY were involved in data acquisition; Tsai YC, Li CC, Chen BT, and Wang CY were involved in the statistical analysis and data interpretation; Tsai YC, Li CC, Chen BT, and Wang CY drafted the manuscript; Tsai YC made the final revisions; All authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read CARE Checklist (2016), and the manuscript was prepared and revised according to CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chien-Yao Wang, MD, Doctor, Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, No. 2, Zhongzheng 1st Road, Lingya District, Kaohsiung 802301, Taiwan. atsb1234@msn.com
Received: March 30, 2023
Peer-review started: March 30, 2023
First decision: April 13, 2023
Revised: April 20, 2023
Accepted: April 27, 2023
Article in press: April 27, 2023
Published online: June 6, 2023
Processing time: 64 Days and 3.8 Hours
Abstract
BACKGROUND

Taiwan has a high prevalence of tuberculosis and urothelial carcinoma. However, the simultaneous occurrence of both disorders in one patient is uncommon. Tuberculosis and urothelial carcinoma share some common risk factors and could demonstrate overlapping clinical manifestations.

CASE SUMMARY

Herein, we report the case of a patient who presented with fever, persistent hematuria, and pyuria. Chest computed tomography scans revealed a bilateral upper lobes cavitary lesion with fibrosis. Severe hydronephrosis of the right kidney and renal stones and cysts in the left kidney were observed. Initial microbiological testing was negative; however, a polymerase chain reaction assay of the urine confirmed a urinary tuberculosis infection. The patient was started on an anti-tuberculosis regimen. Ureteroscopy performed to resolve obstructive nephropathy revealed the incidental finding of a left middle-third ureteral tumor. Examination after biopsy and transurethral resection of the bladder tumor indicated urothelial carcinoma. The patient underwent laparoscopic nephroureterectomy, with bladder cuff excision for the right kidney and ureter, and holmium laser ablation of the ureteral lesion to preserve the left kidney and ureter. He has remained stable after the procedures.

CONCLUSION

Although establishing a causal relationship between tuberculosis and cancer is difficult, medical personnel should consider their correlation.

Keywords: Urinary tuberculosis; Urothelial carcinoma; Fever; Hematuria; Taiwan; Case report

Core Tip: We have reported the case of a patient who presented with fever, persistent hematuria, and pyuria and was diagnosed with both urinary tuberculosis and urothelial carcinoma. Tuberculosis and urothelial carcinoma have some common risk factors such as smoking, alcohol consumption, chronic diseases, and malnutrition. Although it is difficult to establish a causal relationship between these two diseases, clinical medical personnel should consider the correlation between the two diseases.