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Urologic Oncology 2011To highlight the main risk factors for metachronous bladder recurrence after treatment of an upper urinary tract urothelial cell carcinomas (UUT-UCCs) based on the... (Review)
Review
OBJECTIVE
To highlight the main risk factors for metachronous bladder recurrence after treatment of an upper urinary tract urothelial cell carcinomas (UUT-UCCs) based on the recent literature.
MATERIALS AND METHODS
Data on urothelial malignancies after UUT-UCCs management in the literature were searched using MEDLINE and by matching the following key words: urinary tract cancer; bladder carcinomas, urothelial carcinomas, upper urinary tract, renal pelvis, ureter prognosis, carcinoma, transitional cell, renal pelvis, ureter, bladder cancer, cystectomy, nephroureterectomy, minimally invasive surgery, recurrence, and survival.
RESULTS
No evidence level 1 information from prospective randomized trials was available. A range of 15% to 50% of patients with a UUT-UCC will subsequently develop a metachronous bladder UCC. Intraluminal tumor seeding and pan-urothelial field change effect have both been proposed to explain intravesical recurrences. In most cases, bladder cancer arises in the first 2 years after UUT-UCC management. However the risk is lifelong and repeat episodes are common. The identification of variables that allow accurate risk stratification of UUT-UCC patients with regards to future bladder relapse is disappointing. No factors have been identified to date that can reliably predict bladder recurrences. A history of bladder cancer prior to UUT-UCC management and upper tract tumor multifocality are the only frequently reported clinical risk factors among current literature.
CONCLUSION
Prior histories of bladder cancer and upper tract tumor multifocality are the most frequently reported risk factors for bladder tumors following UUT-UCCs. Surveillance regimen is based on cystoscopy and on urinary cytology for at least 5 years.
Topics: Carcinoma, Transitional Cell; Female; Humans; Male; Neoplasm Recurrence, Local; Risk Assessment; Risk Factors; Sex Factors; Urinary Bladder; Urinary Bladder Neoplasms
PubMed: 19762256
DOI: 10.1016/j.urolonc.2009.06.003 -
Academic Radiology Nov 2022
Topics: Humans; Urinary Bladder Neoplasms; Carcinoma, Transitional Cell; Urinary Bladder; Radiomics; Machine Learning; Retrospective Studies
PubMed: 36150963
DOI: 10.1016/j.acra.2022.07.023 -
Journal of the College of Physicians... Apr 2022Cutaneous metastases with a prevalence of 5.3% in all malignancies are rarely observed phenomena in dermatology. Bladder cancers constitute 0.84% of cutaneous...
Cutaneous metastases with a prevalence of 5.3% in all malignancies are rarely observed phenomena in dermatology. Bladder cancers constitute 0.84% of cutaneous metastases; and 90% of these are transitional cell carcinomas (TCCs), the commonest bladder malignancy. However, these metastatic cutaneous lesions are notorious for mimicking many dermatological disorders and show poor prognosis. Herein, we report a 51-year male patient who presented with fibrotic or sclerodermoid type lesions on his both legs and trunk due to cutaneous metastases of bladder urothelial carcinoma. We would like to call attention to these rarely observed skin lesions to prevent delayed diagnosis; and emphasise the use of immunohistochemical staining for the determination of the primary origin of the tumour. Key Words: Cutaneous metastasis, Bladder, Urothelial carcinoma.
Topics: Carcinoma, Transitional Cell; Humans; Male; Skin Neoplasms; Urinary Bladder; Urinary Bladder Neoplasms
PubMed: 35633014
DOI: 10.29271/jcpsp.2022.Supp1.S58 -
Journal of the College of Physicians... Apr 2022We report a rare case of histiocytic sarcoma in association with invasive urothelial carcinoma involving the urinary bladder. A 67-year male patient, who presented with...
We report a rare case of histiocytic sarcoma in association with invasive urothelial carcinoma involving the urinary bladder. A 67-year male patient, who presented with a complaint of macroscopic hematuria, was found to have a mass on urinary system ultrasonography. Abdominal magnetic resonance imaging was performed to evaluate the mass, which showed a 52×24 mm mass on the posterior wall of the bladder. The cystoscopic examination revealed two suspicious areas in close proximity to one another with solid-papillary character. The tissue samples were collected by means of transurethral resection. The evaluation of these samples revealed two distinct neoplastic patterns. The areas of invasive urothelial carcinoma infiltrating lamina propria were noted on the surface in addition to diffuse sheets of large cells with hyperchromatic nuclei and ample clear cytoplasm, with a patternless pattern among small lymphocytes in myxoid background in the lamina propria. The positive reactions were observed in these areas with CD45, fascin, and CD68, a histiocytic marker. The histopathological diagnosis was histiocytic sarcoma in combination with invasive urothelial carcinoma. Histiocytic sarcoma may mimic several other malignant lesions, and only immunohistochemistry can identify this tumour to allow correct treatment. We present this rare case to emphasise that this phenomenon should be considered in unusual tumors and sites. Key Words: Urinary bladder, Histiocytic sarcoma, Invasive urothelial carcinoma.
Topics: Carcinoma, Transitional Cell; Cystectomy; Histiocytic Sarcoma; Humans; Male; Urinary Bladder; Urinary Bladder Neoplasms
PubMed: 35633021
DOI: 10.29271/jcpsp.2022.Supp1.S79 -
American Journal of Clinical Pathology Dec 1988Twelve carcinomas of the urinary bladder with a prominent component of spindle-shaped cells (sarcomatoid carcinomas) that arose in patients from 60 to 83 (average, 71.5... (Review)
Review
Twelve carcinomas of the urinary bladder with a prominent component of spindle-shaped cells (sarcomatoid carcinomas) that arose in patients from 60 to 83 (average, 71.5 years) years of age are reported. The seven male and five female patients typically complained of hematuria. Seven tumors were sessile and five were polypoid. On microscopic examination, the malignant spindle cells merged with in situ transitional cell carcinoma or various forms of invasive carcinoma, including transitional cell carcinoma (11 cases), adenocarcinoma (2 cases), squamous cell carcinoma (2 cases), and small cell undifferentiated carcinoma (2 cases). Immunocytochemical stains were performed in 11 cases; the spindle cells stained for cytokeratin, epithelial membrane antigen, and vimentin. Limited follow-up in this series does not allow for conclusions concerning differences in behavior between sarcomatoid carcinoma and conventional transitional cell carcinoma of similar grade and stage. However, the typically deep invasion of the former tumors and their histologic features indicate that they are highly aggressive neoplasms.
Topics: Aged; Aged, 80 and over; Carcinoma; Female; Humans; Male; Middle Aged; Sarcoma; Urinary Bladder; Urinary Bladder Neoplasms
PubMed: 3057859
DOI: 10.1093/ajcp/90.6.653 -
Journal of Medical Case Reports Aug 2014The occurrence of clear cell tumors in the bladder is not uncommon. Clear cell dysplasia is well-described and characterized by focal replacement of transitional mucosa... (Review)
Review
INTRODUCTION
The occurrence of clear cell tumors in the bladder is not uncommon. Clear cell dysplasia is well-described and characterized by focal replacement of transitional mucosa by cells with abundant clear cytoplasm, nuclear enlargement, and a granular chromatin pattern. Clear cells can also be seen in clear cell adenocarcinoma, which is rare, comprising 0.5% to 2.0% of the reported bladder carcinomas. Other clear cell tumors found in the bladder to be considered in the differential diagnosis are tumors of Müllerian origin and metastatic lesions, such as renal cell carcinoma, clear cell sarcoma, and malignant melanoma. Clear cell urothelial carcinoma is exceedingly rare, with only nine clinical cases described in the literature.
CASE PRESENTATION
We report the case of a 75-year-old Caucasian man who presented with intermittent hematuria, in whom a bladder tumor was identified. A final histopathology examination of a cystoprostatectomy specimen revealed a pT3b, G3 urothelial carcinoma of clear cell type (>90% clear cells) and a prostatic adenocarcinoma of Gleason grade 3+3 (score=6). The bladder tumor consisted of sheets of malignant cells with severe nuclear atypia and abundant clear cytoplasm; no glandular or tubular structures were identified. Tumor cells were periodic acid-Schiff positive and negative after diastase treatment; additional mucicarmine and oil red O stains were negative. Immunohistochemical stains showed the tumor cells positive for cytokeratin 7 (CK7), p63 (>80% nuclei), p53 (about 30% nuclei), vimentin, E-cadherin, cluster of differentiation (CD10), and Ki-67 (>70% nuclei). Stains for cell adhesion molecule 5.2 (CAM 5.2), CD117, cytokeratin 20 (CK20), human melanoma black 45 (HMB-45), paired box protein (PAX 8), placental alkaline phosphatase (PLAP), prostate specific antigen (PSA), renal cell carcinoma (RCC), cancer antigen 25 (CA25), leukocyte common antigen (LC), S-100 protein, and uroplakin III were all negative.
CONCLUSIONS
The tumor marker profile was consistent with clear cell type carcinoma of urothelial origin. Within the differential diagnoses, we ruled out other possible tumor types such as urothelial carcinoma with focal clear cell differentiation, clear cell adenocarcinoma, Müllerian tumors, and metastatic disease.
Topics: Adenocarcinoma; Aged; Biopsy; Carcinoma, Transitional Cell; Cystotomy; Diagnosis, Differential; Humans; Male; Prostatectomy; Prostatic Neoplasms; Urinary Bladder; Urinary Bladder Neoplasms; Urothelium
PubMed: 25124389
DOI: 10.1186/1752-1947-8-275 -
Pathology, Research and Practice Mar 2023Urachal carcinoma, a rare cancer arising from urachus, accounts for about 1% of bladder cancer. The diagnosis at stage I shows about 63% 5-year survival whereas only 8%... (Review)
Review
Urachal carcinoma, a rare cancer arising from urachus, accounts for about 1% of bladder cancer. The diagnosis at stage I shows about 63% 5-year survival whereas only 8% of the patients at stage IV shows a 5-year survival. Above 90% of urachal carcinomas are adenocarcinomas and most of the urachal carcinoma cases are invasive, showing a high resemblance to adenocarcinoma of various origins, making it hard for a conclusive diagnosis. Even though inconclusive, immunohistochemistry can play a significant role in identifying urachal carcinoma. Most cases show the biomarkers CK20 and CDX2, whereas CK7 and β-catenin are expressed at a lesser frequency. Due to the few cases available, there is a lack of evidence regarding specific markers differentiating urachal carcinoma from colorectal or primary bladder adenocarcinomas. In addition to immunohistochemistry, genomic characterization is emerging to play a role in the classification and treatment of the disease. Urachal carcinoma has been reported to have a molecular level similarity with colorectal malignancies regarding certain gene expressions. The TP53 mutations inactivating the tumor suppressor can probably be explored as a possible target in treating urachal carcinoma. Additionally, certain targets identified in gastric and breast cancer along with anti-HER2 treatment strategies can be explored. Immuno-oncology utilizes immune checkpoint inhibitors for the treatment of MSI-H tumors whereas a combination of tyrosine kinase inhibitors along with immune checkpoint inhibitors are being studied to treat MSI stable tumors. The article is an in-depth overview of urachal carcinoma addressing the current landscape with an emphasis on the future scenario.
Topics: Humans; Immune Checkpoint Inhibitors; Urinary Bladder Neoplasms; Adenocarcinoma; Urinary Bladder
PubMed: 36821941
DOI: 10.1016/j.prp.2023.154379 -
Journal of Pediatric Urology Dec 2022Urothelial bladder neoplasm (UBN) is an uncommon lesion in children and adolescents, without established follow-up protocol defined for this patient group.
INTRODUCTION
Urothelial bladder neoplasm (UBN) is an uncommon lesion in children and adolescents, without established follow-up protocol defined for this patient group.
OBJECTIVES
To report our experience and long-term follow-up data on pediatric patients with urothelial carcinoma of the urinary bladder.
METHODS
In this retrospective two center study, we analyzed the perioperative and long-term follow-up data of nine pediatric patients, who presented with neoplasms of urothelial origin within the urinary bladder between 2000 and 2021.
RESULTS
Nine patients were identified with a mean age of 11.9 years (range 4-19 years) and median follow up of 48 months (range 12-160 month). 7 were male. Gross hematuria was the most common presenting symptom, occurring in 6 patients, followed by accidental finding on US, performed for other reasons. Cystoscopy was performed under general anesthesia, and transurethral resection of the bladder tumors was carried out in the same session. All patients had a solitary tumor with a mean size of 11 mm (range 6-15 mm). Pathology revealed 3 cases of papillary urothelial neoplasm of low malignant potential (PUNLMP), 5 cases of low grade (LG) noninvasive urothelial carcinoma (UC) and one case of high-grade (HG) UC invading lamina propria (pT1). All 8 patients with low grade tumor underwent follow up according to adult follow-up protocols without tumor recurrences to date. The single patient with HG pT1 UC, a 14-year-old female after renal transplantation, who was not eligible for intravesical bacillus Calmette-Guerin (BCG) installations due to immunosuppression, underwent 6 sessions of Radiofrequency-induced Thermo-chemotherapy with mitomycin, without complications. She had no recurrence to date, during a 4-year post treatment follow up.
CONCLUSION
Pediatric non muscle invasive bladder cancer (NMIBC), seems to have a good prognosis with infrequent recurrences, which might be in favor of a more spacious follow up plan with less invasive diagnostic modalities as opposed to adult NMIBC population. To the best of our knowledge this is the single description of Heated Intravesical Chemotherapy efficacy for HG UC in the pediatric population.
Topics: Adolescent; Adult; Female; Child; Humans; Male; Infant; Carcinoma, Transitional Cell; Urinary Bladder Neoplasms; Urinary Bladder; Retrospective Studies; Neoplasm Recurrence, Local; Administration, Intravesical; Neoplasm Invasiveness
PubMed: 35871900
DOI: 10.1016/j.jpurol.2022.06.026 -
ANZ Journal of Surgery Jul 2022
Topics: Carcinoma, Transitional Cell; Humans; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Urinary Bladder; Urinary Bladder Neoplasms
PubMed: 34874090
DOI: 10.1111/ans.17415 -
Pathology, Research and Practice Sep 2020Studies have demonstrated an etiologic role of high-risk human papillomavirus (HR-HPV) infection for epithelial malignancies, including most cervical carcinomas,...
Studies have demonstrated an etiologic role of high-risk human papillomavirus (HR-HPV) infection for epithelial malignancies, including most cervical carcinomas, anogenital cancers, and carcinomas of the head and neck; however, a causative role of HPV infection for bladder cancer is controversial. The purpose of this study was to investigate the prevalence of HR-HPV in primary bladder carcinoma to determine the association between HPV infection and the squamous cell component of urothelial carcinoma of the bladder. Furthermore, we evaluated the utility of p16 overexpression as a surrogate marker for HPV infection in these cancers and the correlation of this with tumor stage. Our study included 33 cases of squamous cell carcinoma (SCC) of the urinary bladder. Tumors deemed primary from the bladder were selected and either showed predominant (>50 %) or pure squamous differentiation. Immunohistochemical study for p16 and HR-HPV by RNA in situ hybridization (ISH) was performed in all cases. p16 expression was detected in 7 cases (28 %, 7/25) of urothelial carcinoma with squamous differentiation and not detected in any of the 8 cases (0%, 0/8) of pure SCC. Detection of HR-HPV by ISH was negative in all 33 cases (0%, 0/33). There was no association between p16 overexpression and the presence of HPV infection in squamous cell carcinomas of the bladder. p16 should not be used as a surrogate marker for evidence of HPV infection. Our study suggests that HPV infection does not play an etiologic role in the development of bladder cancer and should not be used as a diagnostic adjunct for these cases.
Topics: Aged; Biomarkers, Tumor; Carcinoma, Squamous Cell; Cyclin-Dependent Kinase Inhibitor p16; DNA, Viral; Female; Humans; Immunohistochemistry; Male; Middle Aged; Risk Factors; Urinary Bladder; Urinary Bladder Neoplasms
PubMed: 32825952
DOI: 10.1016/j.prp.2020.153084