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Case Report with Systematic Literature Review on Vascular Complications of BCG Intravesical Therapy for Bladder Cancer

(1) Background: Intravesical instillation of therapeutic Bacillus Calmette-Guerin (BCG) is the standard of treatment for non-muscular invasive bladder cancer. Although the exact immunomodulatory effects of BCG therapy in non-muscular invasive bladder cancer (NMIBC) are still unclear, it has been con...

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Autores principales: King, Brianna, Singh, Dhanveer, Rathore, Animesh, Flenner, Ronald, Flemmer, Mark
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9604619/
https://www.ncbi.nlm.nih.gov/pubmed/36294547
http://dx.doi.org/10.3390/jcm11206226
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author King, Brianna
Singh, Dhanveer
Rathore, Animesh
Flenner, Ronald
Flemmer, Mark
author_facet King, Brianna
Singh, Dhanveer
Rathore, Animesh
Flenner, Ronald
Flemmer, Mark
author_sort King, Brianna
collection PubMed
description (1) Background: Intravesical instillation of therapeutic Bacillus Calmette-Guerin (BCG) is the standard of treatment for non-muscular invasive bladder cancer. Although the exact immunomodulatory effects of BCG therapy in non-muscular invasive bladder cancer (NMIBC) are still unclear, it has been considered a safe and effective treatment with the largest to-date report of complications citing minimal side effects, none of which included arterial involvement; (2) Methods: A systematic literature review was performed using PubMed, Cochrane, Medline, and Google Scholar from database inception to March 2021. Only eligible studies reporting aneurysm formation in adult patients with a history of BCG immunotherapy and no previous vascular pathology were included; (3) Results: A systematic literature review was conducted, highlighting 17 reports suggestive of BCG-induced mycotic aneurysm development. We added a case of a 78-year-old male, 30 months after last BCG-instillation, with a mycotic abdominal aneurysm yielding Mycobacterium tuberculosis with pyrazinamide resistance culture.; (4) Conclusions: Concluding results suggest a higher incidence of vascular complications from BCG intravesical therapy in the treatment of non-muscular invasive bladder cancer than previously reported. Recommendations are made to emphasize further research of this immunotherapy complication to facilitate the creation of guidelines for diagnosis and management of these patients.
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spelling pubmed-96046192022-10-27 Case Report with Systematic Literature Review on Vascular Complications of BCG Intravesical Therapy for Bladder Cancer King, Brianna Singh, Dhanveer Rathore, Animesh Flenner, Ronald Flemmer, Mark J Clin Med Case Report (1) Background: Intravesical instillation of therapeutic Bacillus Calmette-Guerin (BCG) is the standard of treatment for non-muscular invasive bladder cancer. Although the exact immunomodulatory effects of BCG therapy in non-muscular invasive bladder cancer (NMIBC) are still unclear, it has been considered a safe and effective treatment with the largest to-date report of complications citing minimal side effects, none of which included arterial involvement; (2) Methods: A systematic literature review was performed using PubMed, Cochrane, Medline, and Google Scholar from database inception to March 2021. Only eligible studies reporting aneurysm formation in adult patients with a history of BCG immunotherapy and no previous vascular pathology were included; (3) Results: A systematic literature review was conducted, highlighting 17 reports suggestive of BCG-induced mycotic aneurysm development. We added a case of a 78-year-old male, 30 months after last BCG-instillation, with a mycotic abdominal aneurysm yielding Mycobacterium tuberculosis with pyrazinamide resistance culture.; (4) Conclusions: Concluding results suggest a higher incidence of vascular complications from BCG intravesical therapy in the treatment of non-muscular invasive bladder cancer than previously reported. Recommendations are made to emphasize further research of this immunotherapy complication to facilitate the creation of guidelines for diagnosis and management of these patients. MDPI 2022-10-21 /pmc/articles/PMC9604619/ /pubmed/36294547 http://dx.doi.org/10.3390/jcm11206226 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
King, Brianna
Singh, Dhanveer
Rathore, Animesh
Flenner, Ronald
Flemmer, Mark
Case Report with Systematic Literature Review on Vascular Complications of BCG Intravesical Therapy for Bladder Cancer
title Case Report with Systematic Literature Review on Vascular Complications of BCG Intravesical Therapy for Bladder Cancer
title_full Case Report with Systematic Literature Review on Vascular Complications of BCG Intravesical Therapy for Bladder Cancer
title_fullStr Case Report with Systematic Literature Review on Vascular Complications of BCG Intravesical Therapy for Bladder Cancer
title_full_unstemmed Case Report with Systematic Literature Review on Vascular Complications of BCG Intravesical Therapy for Bladder Cancer
title_short Case Report with Systematic Literature Review on Vascular Complications of BCG Intravesical Therapy for Bladder Cancer
title_sort case report with systematic literature review on vascular complications of bcg intravesical therapy for bladder cancer
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9604619/
https://www.ncbi.nlm.nih.gov/pubmed/36294547
http://dx.doi.org/10.3390/jcm11206226
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