Combination of Neoadjuvant Gemcitabine-Cisplatin and Anti-Tuberculosis Therapy for a Patient With Muscle-Invasive Bladder Cancer and Renal Granulomatosis That Progressed After Intravesical Bacillus Calmette-Guérin Therapy.

INTRODUCTION: A case of muscle-invasive bladder cancer and renal granulomatosis that developed after intravesical Bacillus Calmette-Guérin therapy, in which a combination of neoadjuvant gemcitabine-cisplatin and anti-tuberculosis therapy was safely administered, and radical cystectomy was ultimately performed, is reported.

CASE PRESENTATION: A 64-year-old man with non-muscle-invasive bladder cancer underwent transurethral resection and intravesical Bacillus Calmette-Guérin therapy every time bladder cancer recurred. However, the patient developed left renal granulomatosis during treatment. Anti-tuberculosis therapy was prioritized since there was no bladder cancer progression. However, local bladder cancer progression was observed during the anti-tuberculosis therapy. To successfully cure the renal granulomatosis and suppress tumor progression, neoadjuvant gemcitabine-cisplatin was combined with anti-tuberculosis therapy for 2 months, followed by radical cystectomy. There were no gemcitabine-cisplatin complications and no renal granulomatosis recurrence during combination therapy.

CONCLUSION: Combination of gemcitabine-cisplatin and anti-tuberculosis therapy was possible for a patient with bladder cancer when Bacillus Calmette-Guérin infection was under control.