Adenocarcinoma of the bladder

2017 ◽  
Author(s):  
Roy Mano ◽  
Ofer Yossepowitch
Keyword(s):  
Survival Rates ◽  
Bladder Exstrophy ◽  
Bladder Augmentation ◽  
Urachal Remnant ◽  
Bladder Dome ◽  
Voiding Symptoms ◽  
Localized Disease ◽  
Typical Lesion ◽  
Urachal Adenocarcinoma ◽  
Bladder Adenocarcinoma

Adenocarcinoma of the bladder accounts for 0.5–2 of bladder tumours. Risk factors include bladder exstrophy, bladder augmentation, schistosomiasis, and endometriosis. Bladder adenocarcinoma is classified as primary, arising from the bladder or urachal remnant, and secondary (metastatic). Most patients present with haematuria and irritative voiding symptoms. On imaging, a typical lesion is commonly located at the bladder dome. Compared to urothelial carcinoma (UC), most adenocarcinomas are diagnosed at high grade and advanced stage. Surgical treatment of localized disease entails partial cystectomy for urachal tumours and radical cystectomy for non-urachal or large urachal adenocarcinoma. The optimal treatment for metastatic disease has yet to be defined. Overall survival rates are 20–70% at 5 years, similar to those for UC, when adjusted for stage and grade. Secondary adenocarcinomas commonly arise from a genitourinary or gastrointestinal origin. Differentiation from primary tumours may be complex. Treatment depends on the prognosis of the primary cancer.

scholarly journals Urinary Bladder Adenocarcinoma Metastatic to the Abdominal Wall: Report of a Case with Cytohistologic Correlation

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Vikas Nath ◽  
Mithra Baliga
Keyword(s):  
Abdominal Wall ◽  
Specific Antigen ◽  
Bladder Exstrophy ◽  
Signet Ring Cell ◽  
Ct Guided ◽  
Bladder Dome ◽  
Primary Bladder ◽  
Rare Malignancy ◽  
Urachal Adenocarcinoma ◽  
Bladder Adenocarcinoma

We report a case of adenocarcinoma metastatic to the abdominal wall in a 71-year-old man with a history of primary bladder adenocarcinoma. CT-guided core biopsy was performed; imprints and histologic sections showed malignant glands lined by tumor cells with hyperchromatic nuclei and prominent nucleoli, infiltrating through skeletal muscle. Immunohistochemistry revealed positivity for CK7, membranous/cytoplasmicβ-catenin, caudal-type homeobox transcription factor 2 (CDX2), andα-methylacyl coenzyme A racemase and negativity for CK20, p63, prostate-specific antigen (PSA), and prostate-specific acid phosphatase (PSAP). These findings were interpreted as metastatic adenocarcinoma, consistent with bladder primary. Primary bladder adenocarcinoma is a rare malignancy arising within glandular metaplasia and is associated with cystitis cystica and cystitis glandularis. Predisposing factors include bladder exstrophy, schistosomiasis, and other causes of chronic bladder irritation. This tumor is divided into intestinal, clear cell, and signet ring cell subtypes. Treatment involves radical cystectomy with pelvic lymph node dissection, and prognosis is unfavorable. Primary bladder adenocarcinoma should be differentiated from urachal adenocarcinoma, which arises from urachal remnants near the bladder dome, and secondary adenocarcinoma, or vesical involvement by adenocarcinoma from a different primary. CK7, CK20, CDX2, thrombomodulin, andβ-catenin can help distinguish primary bladder adenocarcinoma from colonic adenocarcinoma; PSA and PSAP can help distinguish primary bladder adenocarcinoma from prostate adenocarcinoma.

Correlation between Histopathology and Natural History of Intestinal-Type Adenocarcinoma and Diffuse Undifferentiated Carcinoma of the Stomach

1973 ◽  
Vol 59 (3) ◽  
pp. 193-217 ◽  
Author(s):  
Silvana Pilotti ◽  
Franco Rilke ◽  
Marcella Del Vecchio
Keyword(s):  
Survival Rates ◽  
Age Groups ◽  
Undifferentiated Carcinoma ◽  
Intestinal Type ◽  
Histological Structure ◽  
Diffuse Type ◽  
Carcinoma Of The Stomach ◽  
History Of ◽  
Localized Disease ◽  
Area North

A total of 400 cases of surgically removed carcinoma of the stomach between 1955 and 1967 were reclassified histologically in two basic types: the adenocarcinoma of intestinal type and the diffuse undifferentiated carcinoma. The identification of both types was possible in all cases, which were then divided thus: 296 (74%) of the intestinal and 104 (26%) of the diffuse type with a ratio of 2.85:1. The papillary, medullary, scirrhous and colloid variants of the intestinal type represented together 31.4% of these cases; the micro-glandular and the colloid variants of the diffuse carcinoma represented 53.8%. In the 127 regional cases (42.9%) of the intestinal type all the lymph node metastases had the same histological structure as the primary whereas in the 43 regional cases (41.3%) of the diffuse type the structure was of the intestinal type in 4 cases (9.3%). Atrophic gastritis and intestinal metaplasia were found in the gastric mucosa adjacent to the tumor in 91.9% of the males and in 91.2% of the females with the intestinal type; corresponding figures for the diffuse carcinoma are 21.6% and 45.9% (p < 0.000000001). Of 296 cases of the intestinal type 194 were males and 102 females with a ratio M/F = 1.90; the ratio for 61 males and 43 females with diffuse carcinoma was 1.41. There was no evidence of a statistical relationship between sex and histological type of tumor. Mean age for males with the intestinal type was 59.0 yrs, with diffuse carcinoma 55.9 (p < 0.05); for females with the intestinal type was 60.6 yrs, and with diffuse carcinoma 55.3 (p < 0.001). The age-group with the highest predominance of diffuse carcinoma was below 55 years (54.8% of the cases). In females below 55 yrs of age the diffuse type was more frequent than the intestinal type. In the three age groups considered (≤ 55, 56–65, ≥ 65 years) the diffuse carcinoma showed the same distribution in both sexes, whereas the intestinal type revealed less uniformity. Survival rates after 5 years followup of 221 patients with localized disease calculated by means of the life table method were 50% for the intestinal type and 42% for the diffuse carcinoma. Median survival time was 4 years and 9 months for the former and 3 years and 6 months for the latter. Adequate information on 264 cases demonstrated that 70% lived in the Province of Milan; the ratio of intestinal type carcinomas to diffuse carcinomas was 3.33 in Brianza (provincial area north of Milan) and 2.05 in the city of Milan. No relevant association was found between blood group and histologic type of carcinoma. From 1955 to 1967 the ratio between the intestinal and the diffuse type in the patients operated in this Institute seemed to indicated a slightly increasing trend.

scholarly journals Self Audit as part time Fistula Surgeon

2018 ◽  
Vol 13 (2) ◽  
Author(s):  
Aziz Abdullah
Keyword(s):  
Fecal Incontinence ◽  
Bladder Exstrophy ◽  
Bladder Augmentation ◽  
Vaginal Route ◽  
Ureteric Injury ◽  
Abdominal Approach ◽  
Part Time ◽  
Continence Rate ◽  
Small Capacity ◽  
Overall Mortality

Aims: To determine the outcome of all the patients operated by single surgeon during this period. Methods: From 2006 to2017 total of 2870 patients were operated. These included all cases of urinary and fecal incontinences, inclusive of both acquired and congenital disorders like cloacal abnormalities and bladder exstrophy. Total 2460 cases of Vvf were operated out of which around 68% were operated via vaginal route remaining were via abdominal routes. Abdominal approach was also used for all cases of ureteric reimplantation and vesico uterine fistula. Total of 5 cases of fecal incontinence with cloacal presentation, all of them were older than 16 years. There were five cases of untreated cases bladder exstrophy all adult females treated with Mitroffnof procedure and bladder augmentation. Of fecal incontinence there were 340 cases out of which 190 cases were of 4th degree tear all of them were operated in similar manner. Around 210 cases of ureteric injury were treated. 10% of them were amenable to endoscopic intervention while remaining were reimplanted. Results: Over all successful closure of fistula was around 95.14%. Unfortunately restoration of continence rate was around 82%. This was mostly because of small capacity of bladder, OAB, Stress Incontinence because of damage to pelvic floor and to the urethra. While overall mortality was 2 patients and these attributed to cardiac causes. Over successive years there is decrease in cases due to obstetrical causes but rise in iatrogenic causes. Though number of cases treated remains same. Conclusions: Overall results are good with reasonable results. Though need further input in trainng of surgeon and midwifes for prevention of fistula. Keywords: audit, fistula, surgeon

DECREASED LINEAR GROWTH ASSOCIATED WITH INTESTINAL BLADDER AUGMENTATION IN CHILDREN WITH BLADDER EXSTROPHY

2000 ◽  
pp. 917-920 ◽  
Author(s):  
DAVID-ALEXANDRE C. GROS ◽  
JENNIFER L. DODSON ◽  
URI A. LOPATIN ◽  
JOHN P. GEARHART ◽  
RICHARD I. SILVER ◽  
...  
Keyword(s):  
Linear Growth ◽  
Bladder Exstrophy ◽  
Bladder Augmentation

scholarly journals Description of a Novel Murine Model for Ileocystoplasty and Early Histologic Changes

2011 ◽  
Vol 11 ◽  
pp. 1325-1331 ◽  
Author(s):  
Matthew R. Braasch ◽  
Thomas S. Griffith ◽  
Christopher S. Cooper ◽  
J. Christopher Austin
Keyword(s):  
Murine Model ◽  
Cellular Proliferation ◽  
Survival Rates ◽  
Bladder Augmentation ◽  
Ki 67 ◽  
Show Evidence ◽  
Cell Layers ◽  
Similar Weight ◽  
Mitotic Figures ◽  
Histologic Changes

There is concern that bladder augmentation with bowel segments predisposes toward the development of carcinoma. Additionally, patients with neurogenic bladder and bladder cancer often present with advanced stage and have poor survival. Cellular hyperproliferation at the urointestinal junction (UIJ) has been implicated in this scenario. We aimed to develop a reproducible murine model of ileocystoplasty (ICP). We also performed preliminary analysis of any early histologic changes with focus on cellular proliferation at the UIJ. Fifteen 6- to 8-week-old female C57BL/6 mice underwent ICP, where a 1-cm ileal segment was used for bladder augmentation. Four sham mice underwent cystotomy and closure, and four mice did not undergo surgery. The mice were euthanized at 12 weeks postsurgery, and paraffin sections were stained for hematoxylin and eosin (H&E). Cellular proliferation was investigated using Ki-67. A novel model of ICP in mice was developed and demonstrated to be technically feasible in approximately 60 min under the operating microscope. Twelve-week postsurgical survival rates were 80% (12 of 15). The surviving mice had a similar weight gain as the sham mice. H&E sections showed thickened urothelium (six to 10 cell layers) at the UIJ, but sparse mitotic figures and no dysplastic changes. Ki-67 staining was rare in the urothelium, and showed no differences between the sham and ICP mice in the bladder or at the UIJ. We here demonstrate the first murine model of ICP. Preliminary studies did not show evidence of early hyperproliferation at the UIJ or in the bladder, but further long-term studies as well as studies with transgenic mice are warranted.

The urachus revisited: multimodal imaging of benign & malignant urachal pathology

2020 ◽  
Vol 93 (1110) ◽  
pp. 20190118
Author(s):  
Jeeban Paul Das ◽  
Hebert Alberto Vargas ◽  
Aoife Lee ◽  
Barry Hutchinson ◽  
Eabhann O'Connor ◽  
...  
Keyword(s):  
Urachal Cyst ◽  
Imaging Features ◽  
Foetal Development ◽  
Urachal Remnant ◽  
Bladder Dome ◽  
Positron Emission ◽  
Patent Urachus ◽  
Urinary Tract Symptoms ◽  
Urachal Sinus ◽  
Ct And Mri

The urachus is a fibrous tube extending from the umbilicus to the anterosuperior bladder dome that usually obliterates at week 12 of gestation, becoming the median umbilical ligament. Urachal pathology occurs when there is incomplete obliteration of this channel during foetal development, resulting in the formation of a urachal cyst, patent urachus, urachal sinus or urachal diverticulum. Patients with persistent urachal remnants may be asymptomatic or present with lower abdominal or urinary tract symptoms and can develop complications. The purpose of this review is to describe imaging features of urachal remnant pathology and potential benign and malignant complications on ultrasound, CT, positron emission tomography CT and MRI.

Primary Adenocarcinoma of the Urinary Bladder: Differential Diagnosis and Clinical Relevance

2013 ◽  
Vol 137 (3) ◽  
pp. 371-381 ◽  
Author(s):  
Minghao Zhong ◽  
Elizabeth Gersbach ◽  
Stephen M. Rohan ◽  
Ximing J. Yang
Keyword(s):  
Differential Diagnosis ◽  
Urinary Bladder ◽  
Urothelial Carcinoma ◽  
World Health ◽  
Primary Adenocarcinoma ◽  
Secondary Malignancies ◽  
Nephrogenic Adenoma ◽  
Urachal Remnant ◽  
Primary Bladder ◽  
Bladder Adenocarcinoma

Context.—Glandular lesions of the urinary bladder include a broad spectrum of entities ranging from completely benign glandular lesions to primary and secondary malignancies. Common benign bladder lesions that exhibit glandular differentiation include cystitis cystica, cystitis glandularis, von Brunn nests, nephrogenic adenoma, intestinal metaplasia, urachal remnant, endometriosis, and prostatic-type polyp. The World Health Organization defines primary adenocarcinoma of the bladder as an epithelial malignancy with pure glandular differentiation without evidence of typical urothelial carcinoma. Malignant lesions that should be included in the differential diagnosis of a primary adenocarcinoma of the bladder include noninvasive and invasive urothelial carcinoma with glandular differentiation and secondary malignancies involving the bladder by direct extension or metastasis. The recognition and distinction of these different entities may be a challenge for pathologists, but they are of great clinical importance. Objective.—To review features of primary bladder adenocarcinoma as well as those entities that need to be differentiated from primary bladder adenocarcinoma, with emphasis on clinical findings, pathologic characteristics, and immunoprofiles. Data Sources.—Selected original articles published in the PubMed service of the US National Library of Medicine. Conclusions.—The accurate diagnosis of adenocarcinoma of the urinary bladder is important and challenging. It has to prompt an extensive clinical workup to rule out other glandular lesions in the urinary bladder, especially the possibility of secondary involvement of the bladder by an adenocarcinoma from a different site.

806 Primary closure compared to bladder augmentation with a collagen scaffold in a model for bladder exstrophy

2012 ◽  
Vol 11 (1) ◽  
pp. e806-e806a
Author(s):  
L.A.J. Roelofs ◽  
B.B.M. Kortmann ◽  
R.M.H. Wijnen ◽  
A.J. Eggink ◽  
T.M. Tiemessen ◽  
...  
Keyword(s):  
Primary Closure ◽  
Bladder Exstrophy ◽  
Collagen Scaffold ◽  
Bladder Augmentation
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