ArticleIJU case reports2026
Metastasis-Directed Surgery for Solitary Pulmonary Metastasis After Pembrolizumab in Urothelial Carcinoma: A Case Report.
Article in IJU case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: The role of metastasis-directed therapy in urothelial carcinoma remains uncertain, particularly in the immune checkpoint inhibitor era. We report a case of solitary pulmonary metastasis that developed after a favorable response to pembrolizumab and was managed with metastasectomy. Case Presentation: A 65-year-old man with ureteral carcinoma underwent radical nephroureterectomy followed by adjuvant gemcitabine plus carboplatin. Three months later, a solitary pulmonary metastasis was detected and pembrolizumab was initiated. After initial enlargement, the lesion regressed and achieved a partial response after 13 cycles, followed by slight regrowth after 18 cycles, consistent with oligoprogression. Video-assisted thoracoscopic metastasectomy was performed 14 months after pembrolizumab initiation. Pembrolizumab was continued for 1 year postoperatively, with no recurrence observed 17 months after surgery. Conclusion: This case suggests that metastasis-directed therapy may be a reasonable option for carefully selected patients with oligoprogressive urothelial carcinoma during immune checkpoint inhibitor therapy.
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