Giant cell tumor-like lesion of the urinary bladder: a report of two cases and literature review; giant cell tumor or undifferentiated carcinoma?

Abstract

SummaryGiant cell tumor, excluding its prototype in bone, is usually a benign but local aggressive neoplasm originating from tendon sheath or soft tissue. Malignant behavior is uncommon. Visceral organ involvement including urinary bladder is rare. Giant cell tumors in visceral organs usually accompany epithelial tumors and the clinical behavior of giant cell tumor in urinary bladder is similar to its bone counterpart. Here, we report two cases of giant cell tumor located in urinary bladder in comparison with nine reported cases in the English literature. Concurrent noninvasive urothelial carcinoma was also described in all these previous reports and only one patient with follow-up died of disease. One of the two cases we present had no concurrent urothelial tumor at the time of diagnosis but had a history of a low grade noninvasive urothelial carcinoma with three recurrences. The histology of these two cases was similar to the giant cell tumor of bone and composed of oval to spindle mononuclear cells with evenly spaced osteoclast-like giant cells. Immunohistochemically, the giant cells showed staining with osteoclastic markers including CD68, TRAP, and LCA. Immunohistochemical expression of vimentin, CD68, LCA, and smooth muscle actin in mononuclear cells supported a mesenchymal origin with histiocytic lineage. The histologic and immunohistochemical properties in our cases as well as their clinical courses were consistent with a giant cell tumor. Consequently, tumors in urinary bladder showing features of giant cell tumor of bone may also be considered and termed "giant cell tumor".

An expanded immunohistochemical profile of osteoclast-rich undifferentiated carcinoma of the urinary tract

“…ORUCUT has been rarely described in the literature with approximately 20 case reports and small case series reported to date [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33]. The largest prior case series by one of the current authors (JIE) on only six cases concluded that the mononuclear cells in ORUCUT were derived from urothelium based on three main findings: (1) the presence of at least focal epithelial staining (either AE1/3, Cam5.2, CK7 and or EMA) in 4/6 cases;…”

Large cell neuroendocrine carcinoma (LCNEC) of the urinary bladder: a case report

“…Mixed histology is also seen in other rare primary bladder tumors such as adult rhabdomyosarcoma [15] or giant cell tumor [16]. …”

Differential Expression of ADAM23, CDKN2A (P16), MMP14 and VIM Associated with Giant Cell Tumor of Bone

“…Studies of the ectopic overexpression of vimentin have shown the invasive behavior of epithelial carcinoma cells, which reveal the association of vimentin with tumor invasiveness and motility 84, 85. One previous study found expression of VIM in mononuclear cells of GCTB 86. Our results show that the increased expression of vimentin in multinucleated giant cells, stromal cells and monocytic cells of GCTB is significantly associated with GCTB, and therefore, the increased expression of vimentin may act as a new indicator of this tumor.…”