Evidence map›Paper›PMID 42607018›Full record

ArticleThe American journal of case reports2026

A Case Report of a 64-Year-Old Man With Urothelial Carcinoma With Brain and Leptomeningeal Metastases Treated With Intrathecal Methotrexate as Part of Multimodal Management.

Leland F Damron, Leigh Kinney, Nikhita Kathuria-Prakash, Marilena Iliopoulos, Dimitrios Stefanoudakis, Lidia P Lopez, Marah Sakkal, Negar Khanlou, Steven D Hart, Neda A Moatamed and 2 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in The American journal of 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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0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Leland F DamronDepartment of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Leigh KinneyDepartment of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Nikhita Kathuria-PrakashDivision of Hematology/Oncology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Marilena IliopoulosMarymount High School, Los Angeles, CA, USA.
Dimitrios StefanoudakisDepartment of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Lidia P LopezDivision of Hematology/Oncology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Marah SakkalDepartment of Radiology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.ORCID 0009-0006-1625-3338
Negar KhanlouDepartment of Pathology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Steven D HartDepartment of Pathology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Neda A MoatamedDepartment of Pathology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Nicolaos J PalaskasDivision of Hematology/Oncology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Alexandra DrakakiDivision of Hematology/Oncology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND The central nervous system (CNS) is a rare site for upper tract urothelial carcinoma (UTUC) metastasis and typically carries a poor prognosis. Little is known about effective treatments. This report describes a 64-year-old man with UTUC with brain and leptomeningeal metastases. He was treated with multiple lines of chemotherapy, immunotherapy, surgery, radiation, and intrathecal methotrexate as part of multimodal therapy delivered through multidisciplinary care. CASE REPORT A 64-year-old man with multiple sclerosis was diagnosed with UTUC. Initial management included a nephroureterectomy followed by platinum-based chemotherapy. Despite this treatment, his malignancy recurred with pulmonary metastases, treated with enfortumab vedotin and local ablation. After this treatment, he achieved systemic disease control. However, he later presented with neurologic symptoms, and imaging showed brain metastases. He underwent resection followed by stereotactic radiation therapy and immunotherapy. Even with this multimodal treatment, he developed leptomeningeal spread, evidenced by cytology-positive cerebrospinal fluid (CSF). Following progression on multiple systemic therapies, he received intrathecal methotrexate with temporary clearance of tumor cells from his CSF before disease progression. This treatment course, including chemotherapy, immunotherapy, and intrathecal methotrexate, prolonged the patient's life before he unfortunately died from his disease. CONCLUSIONS This case report outlines a treatment approach for a rare complication of UTUC. This regimen includes both standard-of-care therapy and inventive strategies extrapolated from data on other solid tumors. Additionally, it contributes to the limited data on the management of CNS metastasis in rare solid tumor malignancies, which could inform future clinical decision-making.

Indexed as

Antimetabolites, AntineoplasticBrain NeoplasmsCarcinoma, Transitional CellMeningeal CarcinomatosisMeningeal NeoplasmsMethotrexateCombined Modality TherapyHumansInjections, SpinalMaleMiddle AgedAntimetabolites, AntineoplasticMethotrexate

Identifiers

PMID42607018
PMCPMC13495735

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.