An Intracranial Tumor Appeared Two Months after the Operation of Bladder Cancer: Metastatic or Primary?

It is common for an intracranial mass to occur after another malignancy, which is usually metastasis. There are also reports that intracranial tumors have appeared years after another carcinoma had been previously treated with radiotherapy or chemotherapy. In the latter case, the intracranial tumor is usually attributed to metastasis or a secondary primary malignancy. There are also some hereditary or familial syndromes that present with multiple tumors, e.g., Li Fraumeni, Lynch, and Turcot syndrome. For these syndromes, the proband cancer generally occurs in children and young adults with a definitive familial aggregation. However, we found no previous reports of the appearance of a primary glioma only 2 months after a bladder cancer carcinectomy in an old patient without a typical family history. Here, we report the case of a 59-year-old female who complained of a constant headache for one week at the time of admission. Only 2 months before, she had undergone a bladder cancer carcinectomy. Upon admission, a cranial MRI scan revealed right temporal lobe lesions, and the post-operative pathological diagnosis was anaplastic astrocytoma. Cases such as these are easily misdiagnosed, and the opportunity for surgical treatment can be lost. Moreover, the appearance of two concurrent cancers or the occurrence of one after another within a very short interval in different body parts has rarely been reported. Therefore, this case may provide neurosurgeons with knowledge of an uncommon clinical experience that could reduce misdiagnosis and mistreatment.