Primary Clear Cell Carcinoma of the Urinary Bladder

Abstract

Primary clear cell carcinoma of the urinary bladder (PCCUB) is rare. Literature review has revealed 47 cases of PCCUB which commonly affects women. The histogenesis of PCCUB is not certain and Müllerian origin and urotheilal origin have been postulated. The microscopic characteristics of PCCUB include cells with abundant clear cytoplasm, arranged in a solid, glandular, tubulocystic, or papillary pattern. The cells may be flat or cuboidal with abundant clear eosinophilic cytoplasm. Hobnailing may be evident. PCCUB, on immunohistochemistry, stain positively with pan-cytokeratin, cytokeratin 7, and CA 125. PCCUB may manifest with visible haematuria, lower urinary tract symptoms, and discharge. There is no consensus opinion regarding the best treatment option for PCCUBs and patient outcomes are not very clear. Surgery has been the adopted treatment of choice. Differential diagnoses of PCCUB include nephrogenic metaplasia, urothelial carcinoma with clear cell cytoplasm, diffuse large B-cell lymphoma, and metastatic clear cell carcinoma with the primary originating elsewhere. Conclusions. A thorough radiological imaging assessment is required in cases of PCCUB to exclude a primary tumour elsewhere. Urologists and oncologists should report cases of PCCUB they encounter and should enter them into a multicentric trial to ascertain the best management option.

Non-muscle-invasive clear cell carcinoma of the urinary bladder: Is cystectomy necessary?

“…Dow and Young1 first reported a case in 1968 since then there have been a total of 49 cases reported including the case presented in this paper. In the literature, the following suggestions have been made regarding the origin of clear cell bladder carcinoma2: (A) originates from the mullerian system in the urinary bladder, (B) is an adenocarcinoma of non-mullerian origin that has features of CCC and (C) is a variant of urothelial carcinoma that has undergone glandular differentiation.…”

“…The prognosis of CCC of the bladder is not well understood as it is a rare tumour and the follow-up post-treatment has mostly been less than 5 years 2. Surgery, which involves cystectomy, has been the primary method of treatment of clear cell bladder carcinoma as it is mostly diagnosed when the tumour is in its advanced stages.…”

“…There have been seven cases of non-muscle-invasive CCC reported in the literature. Of these, 43% of patients (3/7) have been treated by TURBT alone, 43% of patients (3/7) were treated with radical cystectomy and 14% of patients (1/7) have been initially treated with TURBT followed by chemotherapy 2…”

Rare case of primary clear cell carcinoma of the urinary bladder

“…CCA of urinary tract is rare, with only sporadic cases reported in literature 3. Till date, less than fifty cases have been reported 3.…”

Clear Cell Adenocarcinoma of the Urinary Bladder Is a Glycogen-Rich Tumor with Poorer Prognosis

“…Since there are no distinguishing symptoms of CCA, diagnosis is based on histopathological identification of these characteristics. Due to its rarity, information on the characteristics and prognosis of CCA have been limited to case reports, with less than 50 cases reported to date [19][20][21]. The largest existing literature review was performed by Lu et al, consisting of 38 case reports [21].…”