Late Local Recurrence of Carcinoma <i>in situ </i>- Only Bladder Cancer

Late recurrence (LR) of bladder cancer after radical cystectomy (RC) is rare, and few studies have been conducted. We report a case of local LR of bladder cancer 10.3 years after RC. The pathology at RC was almost carcinoma <i>in situ</i> (CIS) only. The patient underwent metastasectomy, and treatment with an immune checkpoint inhibitor (ICI) achieved a complete response (CR). A 61-year-old woman was referred to our hospital for macrohematuria and bladder irritability in June 2012. She underwent RC along with pelvic lymph node dissection and ileal conduit creation. The pathologic findings were CIS, G2>G3, pT1, pN0. She visited our hospital with complaints of lower abdominal discomfort in November 2022, and recurrence was found on the pelvic floor by abdominal computed tomography. Metastasectomy confirmed metastasis of urothelial carcinoma. As salvage therapy, systemic chemotherapy with a platinum agent and an ICI were administered, leading to CR. Long-term follow-up should be considered for patients with bladder cancer, even for early-stage CIS-only tumors. Metastasectomy could be the primary option for LR of bladder cancer after RC.