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Title: Atraumatic chylous ascites: an unusual presentation of bladder cancer.
Austin Authors: Srinivasan, Ashish ;Apostolov, Ross ;Leong, Amanda ;Johnson, Douglas F
Affiliation: Department of Gastroenterology, Austin Health, Heidelberg, Victoria, Australia
Department of General Medicine, Austin Health, Heidelberg, Victoria, Australia
Issue Date: 4-May-2017 2017-05-04
Publication information: BMJ Case Reports 2017; 2017: bcr-2016-219006
Abstract: We describe a case of bladder cancer presenting with atraumatic chylous ascites, which remains an extremely rare presentation of this condition. A previously well, elderly ex-smoker with no prior history of abdominal surgery was referred for investigation of progressive dyspnoea, increasing peripheral oedema and new-onset ascites, on a background of long-standing alcohol consumption (four standard drinks daily). Liver biochemistry and coagulation profile were normal apart from marked hypoalbuminaemia. Doppler ultrasound of the liver demonstrated normal echotexture and patent vasculature. Abdominal paracentesis yielded 8 L of milk-coloured, triglyceride-rich fluid with abundant malignant cells. Urine cytology demonstrated malignant transitional cells, with radiological evidence of a large enhancing bladder mass, with evidence of adjacent lymphadenopathy and omental involvement. A diagnosis of metastatic stage IV transitional cell bladder cancer was made. The patient declined palliative chemotherapy and passed away 2 months after their initial presentation.
DOI: 10.1136/bcr-2016-219006
PubMed URL: 28473429
Type: Journal Article
Subjects: Liver disease
Urological cancer
Appears in Collections:Journal articles

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