# 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

## TL;DR

A patient with bladder cancer and kidney granulomatosis was successfully treated with a combination of chemotherapy and anti-tuberculosis therapy before surgery.

## Contribution

Demonstrates the safe use of gemcitabine-cisplatin alongside anti-tuberculosis therapy in a complex clinical case.

## Key findings

- Combining neoadjuvant gemcitabine-cisplatin with anti-tuberculosis therapy was feasible and safe.
- Radical cystectomy was successfully performed after the combination therapy.
- No complications or recurrence of granulomatosis were observed during treatment.

## Abstract

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.

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.

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