A new and reliable culture system for superficial low-grade urothelial carcinoma of the bladder

Abstract Context.—Human carcinoma–associated antigen (HCA) is a mucin protein whose level is increased in the sera of patients with a variety of carcinomas. We have previously shown that prostatic carcinoma overexpresses HCA in comparison to benign prostatic tissue. To our knowledge, expression of HCA in other tumors has not been reported previously. Objective.—The current study was designed to determine if HCA is overexpressed in urothelial carcinoma (UCa) of the bladder. Design.—Forty cystectomy specimens with UCa were selected, of which 27 cases had invasive UCa, 21 cases had a noninvasive component, and 36 cases had benign urothelium. Seven cystectomy specimens with benign conditions were chosen as controls. Anti-HCA monoclonal antibody HAE3 was used for immunohistochemical staining. Results were recorded as positive (≥5% of cells staining and staining intensity 2+ or 3+) or negative (<5% of cells staining or staining intensity <2+) and analyzed using the Fisher exact test. Results.—HAE3 staining was positive in 67% of invasive UCa, 29% of noninvasive UCa, but only 5% of benign urothelium specimens. The difference in HCA expression between benign urothelium and UCa and that between invasive and noninvasive UCa was statistically significant (P = .008). No statistically significant difference was found between low-grade and high-grade noninvasive papillary UCa (P = .06). Conclusions.—Human carcinoma–associated antigen is selectively overexpressed in a significant number of cases of UCa of the bladder, suggesting the potential utility of monitoring the serum and/or urine levels of HCA in monitoring patients with HCA-positive UCa for recurrence or progression.

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Low Grade Lymphoma Mimicking Metastatic Urothelial Carcinoma: When Do We Need Further Histologic Staging?

Case Reports in Oncological Medicine ◽

10.1155/2016/8125898 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6

Author(s):

Azka Ali ◽

William P. Skelton IV ◽

Neeka N. Akhavan ◽

Thu-Cuc Nguyen ◽

Zachary A. Taylor ◽

...

Keyword(s):

Lymph Nodes ◽

Urothelial Carcinoma ◽

Systemic Chemotherapy ◽

Secondary Malignancy ◽

Low Grade ◽

Radiographic Imaging ◽

Regional Lymph Nodes ◽

Case Presentation ◽

Metastatic Urothelial Carcinoma ◽

Carcinoma Of The Bladder

Introduction.Patients with urothelial carcinoma of the bladder often present with metastases to regional lymph nodes, with lymphadenopathy on physical examination or radiographic imaging.Case Presentation.We present the case of a 73-year-old Caucasian man with presumed metastatic urothelial carcinoma of the bladder to regional pelvic and retroperitoneal lymph nodes. He underwent systemic chemotherapy for treatment of urothelial carcinoma and was discovered on restaging to have findings suggestive of disease progression but ultimately was found to have a concurrent secondary malignancy.Conclusion.Our case suggests that in patients with urothelial carcinoma, the concurrent presentation of regional lymphadenopathy may not be metastatic urothelial carcinoma and may warrant further investigation.

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UGN-101 (mitomycin gel): a novel treatment for low-grade upper tract urothelial carcinoma

Therapeutic Advances in Medical Oncology ◽

10.1177/1758835920937950 ◽

2020 ◽

Vol 12 ◽

pp. 175883592093795

Author(s):

Andrea Kokorovic ◽

Surena F. Matin

Keyword(s):

Urothelial Carcinoma ◽

Mitomycin C ◽

Unmet Need ◽

Invasive Disease ◽

Upper Tract Urothelial Carcinoma ◽

Phase Iii ◽

Low Grade ◽

Upper Tract ◽

Carcinoma Of The Bladder ◽

Rare Malignancy

Upper tract urothelial carcinoma (UTUC) is a rare malignancy. The standard treatment for localized high-risk disease is radical nephroureterectomy, which confers significant morbidity and is not appropriate for all patients. Patients harboring low-risk, non-invasive disease may be candidates for organ-sparing treatment, which includes endoscopic resection with or without intracavitary drug therapy. Successful administration of intracavitary chemotherapy to the upper tracts is impeded by rapid washout of the agent and short dwell times. This has limited the clinical utility of mitomycin C for treatment of upper tract tumors, despite the successful outcomes observed in low-grade urothelial carcinoma of the bladder. Currently, there is an unmet need for development of a technically feasible and oncologically sound intracavitary therapy for management of low-grade UTUC. UGN-101 (Jelmyto™) is a novel formulation of mitomycin C that uses a unique hydrogel designed to increase urinary dwell time, and thereby efficacy of treatment. Preclinical data demonstrated promising results regarding the safety and feasibility of this agent. Preliminary results of a phase III trial (OLYMPUS study) [ClinicalTrials.gov identifier: NCT02793128] demonstrated the efficacy of UGN-101 as a successful chemo-ablative agent for low-grade upper tract tumors. UGN-101 may represent a pivotal paradigm shift in the treatment of low-grade UTUC. Indeed, the drug has recently been granted approval by the US Food and Drug Administration as the first treatment for low-grade UTUC, which may lead to significant improvements in patient care and a long-awaited decrease in the burden of disease.

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Vulvar Paget disease secondary to high-grade urothelial carcinoma with underlying massive vascular embolization and cervical involvement: case report of unusual presentation

Diagnostic Pathology ◽

10.1186/s13000-019-0895-0 ◽

2019 ◽

Vol 14 (1) ◽

Author(s):

Walquiria Quida Salles Pereira Primo ◽

Guttenberg Rodrigues Pereira Primo ◽

Dunya Bachour Basilio ◽

Karime Kalil Machado ◽

Jesus Paula Carvalho ◽

...

Keyword(s):

Urothelial Carcinoma ◽

Immunohistochemical Analysis ◽

Low Grade ◽

High Grade ◽

Paget Disease ◽

Careful Clinical Examination ◽

History Of ◽

Carcinoma Of The Bladder ◽

Tumor Emboli ◽

Specific Symptoms

Abstract Background Vulvar extramammary Paget disease is a rare chronic condition, that presents with non-specific symptoms such as pruritus and eczematous lesions. Because most of these lesions are noninvasive, the distinction between primary and secondary Paget disease is crucial to management. Case presentation We report an unusual case of vulvar Paget disease associated with massive dermal vascular embolization, cervicovaginal involvement and metastasis to inguinal and retroperitoneal lymph nodes. The intraepithelial vulvar lesion had a classical appearance and was accompanied by extensive component of dermal lymphovascular tumor emboli, similar to those observed in inflammatory breast carcinoma. Immunohistochemical analysis revealed that the lesion was secondary to high-grade urothelial cell carcinoma. The patient had a history of superficial low-grade papillary urothelial carcinoma of the bladder, which had appeared 2 years before the onset of vulvar symptoms. Conclusions Eczematoid vulvar lesions merit careful clinical examination and biopsy, including vulva mapping and immunohistochemistry. The information obtained may help to define and classify a particular presentation of Paget disease. Noninvasive primary lesions do not require the same aggressive approaches required for the treatment of invasive and secondary disease.

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