Terrence (81 years old)

Terrence, 81 years old, was in his younger years a physical education teacher and in his free time the trainer of the local kids’ football team. His health does not allow him anymore to train the kids himself, but he still watches every match the team plays.

He was diagnosed with MIBC cT2N0M0 and underwent RC without receiving neoadjuvant chemotherapy because he was cisplatin-ineligible. The pathological review of the RC specimen indicated pT2b pN0 (0/10) R0, PD-L1 positive. He did not receive adjuvant therapy. First follow-up scans were normal, however, 15 months after surgery, he presents with intrathoracic lymph node metastases.

Assessment summary:

• Medical history: hypertension, chronic kidney disease
• ECOG PS: 1
• CT scan reveals intrathoracic lymph node metastases, biopsy compatible with UCa
• Peripheral neuropathy grade 1
• Audiometric hearing loss grade 2
• GFR: 45 ml/min
• Activating FGFR3 mutation in diagnostic biopsy specimen