Primary adenocarcinoma of the urinary bladder:

Abstract

Objective To evaluate the outcome after the treatment of primary non‐urachal vesical adenocarcinoma and to determine the significant prognostic factors. Patients and methods The records of 185 patients with vesical adenocarcinoma were reviewed. The pathological evaluation included the determination of pathological stage, tumour grade, presence or absence of mucin and its location, evidence of bilharzial infestation and flow‐cytometric DNA analysis. The mean follow‐up of the treated patients was 3.1 years. Disease‐free survival was estimated and the results correlated with patient and tumour characteristics (univariate analysis). Cox’s proportional hazards analysis was used to determine prognostic factors. Results The overall 5‐year disease‐free survival was 55%; only three factors had a significant impact on survival, the tumour pathological stage and grade, and lymph node involvement. Conclusions Radical cystectomy remains the only satisfactory treatment option for primary vesical adenocarcinoma. Tumour stage, grade and lymph node involvement are the only significant prognostic factors.

Differences in survival among patients with urachal and nonurachal adenocarcinomas of the bladder

“…2,3,[7][8][9] In 1 of the larger series reporting on both types, there was a trend toward improved survival in subjects with urachal adenocarcinoma, although it did not reach statistical significance (P ¼ .07). 3 In that series of 24 urachal and 48 nonurachal tumors, the 5-year survivals were 61% vs. 31%, respectively.…”

“…The higher rate reported from single institutions specializing in urologic oncology likely reflects the referral pattern of these rare tumors, rather than the true relative incidence of urachal and nonurachal adenocarcinomas. el-Mekresh et al 8 reported the largest series on primary bladder adenocarcinoma from Egypt, where bilharziasis is endemic and is associated with a higher risk of bladder adenocarcinomas. Whereas adenocarcinomas account for less than 2% of all bladder cancers in most series, 10% of all bladder cancers in the el-Mekresh et al report were adenocarcinomas.…”

“…11 Other factors associated with poor survival include higher stage 3,5,6,8 and grade. 2,3,5,8 There are reasons to consider that outcomes may be different between urachal and nonurachal adenocarcinomas of the bladder. The demographics are different, with urachal tumors reported to occur in younger patients.…”

The 2016 WHO Classification of Tumours of the Urinary System and Male Genital Organs—Part B: Prostate and Bladder Tumours

“…Interestingly, recent genomic data have described a basal/squamous-like molecular subtype that has squamoid morphology and immunophenotype and is associated with poor survival and poor response to systemic therapy [69,70]. Glandular neoplasms constitute the second most common form of divergent differentiation, seen in up to 18% of invasive tumours and defined by the presence of gland formation [71][72][73]. These tumours commonly have enteric features and, in isolation, can be easily confused with colonic adenocarcinoma.…”

Primary signet-ring cell adenocarcinoma of the urinary bladder: a case report

“…Progressive invagination of hyperplastic epithelial buds into the lamina propia (Von Brunn's nest) leads to the formation of cystitis cystica. Subsequent, metaplasia of the urothelial lining to these cyst to columnar mucin-producing cells results in the production of cystitis glandularis, which is premalignant lesion 2 . Alternatively, cuboidal or columnar metaplasia of the surface epithelium can occur with no downward invagination, Chronic vesical irritation and infection are the predisposing factors of theses changes.…”