Metastatic signet ring cell adenocarcinoma of the bladder:

Abstract

Signet ring cell variant of mucinous adenocarcinoma of the urinarybladder is an exceptionally rare urologic malignancy, generally feltto be resistant to chemotherapy and radiotherapy. We describe acase of this malignancy with unusual sites of metastasis and anunexpectedly good response to treatment.

Primary Urachal Mucinous Adenocarcinoma of the Urinary Bladder

“…Partial cystectomy or transurethral resection may be indicated for small, well-demarcated primary bladder or urachal adenocarcinoma with long-term survival [12,13,14]. Radical cystectomy is generally favoured over partial cystectomy, particularly for non-urachal tumours, because of the possibility of local invasion being undetected on imaging [13].…”

Metastatic signet-ring cell carcinoma of the urinary bladder: A novel management approach to a rare tumor.

“…Our case, however, highlights the use of the FOLFOX-6 regimen specifically and is the first to report treatment response of an osseous metastasis. 5,12 Similarly, one report describes response to palliative chemotherapy with the FOLFOX-6 regimen plus bevacizumab in the treatment of typical bladder adenocarcinoma, but ours is the first to describe response of the signet-ring cell variant specifically, and with the use of FOLFOX-6 alone. 13 Our patient's response to FOLFOX-6 supports the use of a therapy traditionally aimed at gastrointestinal malignancies for the treatment of metastatic SRCC of the bladder.…”

“…Immunohistochemical staining using CK7 and CK20 can also be helpful in evaluating the cancer's primary origin, although a distinct immunohistochemical profile for primary SRCC has not been ascertained. 5,11 Our case provides a unique diagnostic approach by using NGS to understand the genetic characteristics of this unusual tumour and ultimately guide our choice of systemic therapy. NGS may be valuable in the management of these rare tumours by identifying specific molecular drivers that can be targeted pharmaceutically.…”

“…[2][3][4] Due to its rarity, no standard treatment algorithm exists, especially for the management of metastatic disease after initial surgical intervention. 3,5 We report a case of primary bladder SRCC with recurrent metastases post-cystectomy; the patient exhibited response to palliative chemotherapy with a modified FOLFOX-6 regimen.…”

Metastasis of Gastric Signet-Ring Cell Carcinoma to the Urinary Bladder: A Case Report and Review of the Literature

“…In bladder tumors, SRC histologic type is very rare. When SRC carcinoma histology is encountered in the bladder of a patient, primary SRC carcinoma of the bladder and bladder metastasis of a malignancy of gastrointestinal system origin are primarily included in the differential diagnosis [ 4 ]. It is important to distinguish these two conditions because their treatment and prognosis are different.…”