Primary Mucinous Adenocarcinoma of the Urinary Bladder with Signet-Ring Cells: Description of an Uncommon Case and Critical Points in Its Management

Abstract

We present an uncommon case of mucinous adenocarcinoma of the bladder (MAB) with signet-ring cells extensively infiltrating prostate gland and pelvic/retroperitoneal lymph node stations and not responsive to usual systemic chemotherapy regimens. This case highlights the important features of MAB including the pattern of tumor spread, the tendency for initial misdiagnosis, and the importance of immunohistochemical study in order to define its primary origin from the bladder and choose the most appropriate treatment since the beginning.

Mucinous Adenocarcinoma (Signet Ring Cell Carcinoma) of the Urinary Bladder in Young Male: A Case Report

“…Wang et al reported 90 % expression of thrombomodulin in urothelial carcinoma and expressed only in 59 % of cases of adenocarcinoma of the urinary bladder, and unexpressed in cases of colon adenocarcinoma (5,8,13). The staining of CK20, CK7, and CDX2 is not able to distinguish both of them.…”

“…Adjuvant chemotherapy can improve long-term survival in patients who get early cystectomy. Until now there is no standard chemotherapy for primary adenocarcinoma of the urinary bladder due to their rarity (5,10). Cobo-Dols et al reported a case of primary signet ring cell carcinoma treated successfully with total cystectomy followed by systemic chemotherapy with cisplatin and gemcitabine, a standard combination for transitional carcinoma of the urinary bladder (10).…”

“…This tumor has overlapping histologic characteristics with adenocarcinoma derived from other primary sites such as colorectal, prostate, and gynecology. Diagnosis is often delayed because it is very difficult to determine its primary location, so palliative chemotherapy becomes a possible therapy in nearly 50% of patients (5)(6)(7). We will report a case of primary mucinous adenocarcinoma (signet ring cell carcinoma) of the urinary bladder that occurred in a 29-yearold male.…”

Mucinous adenocarcinoma of the prostatic urethra following a remote history of primary brachytherapy for prostate cancer

“… 12 Indeed, when using these colorectal regimens for mucinous adenocarcinoma of the bladder, case reports have shown a clinical response. 13 Therefore, in the absence of strong clinical evidence, clinicians will have to rely on case reports, draw from the colorectal literature, and maintain a shared decision-making process with the patient, to guide management of this rare malignancy.…”

Mucinous adenocarcinoma of renal pelvis in a young male: a diagnostic challenge

“…2) [ 11 ]. The typical immunohistochemical profile of adenocarcinoma of the urothelial region comprises of positivity for CK7, CK20, CDX2, EMA, villin, MUC1, MUC2, and MUC3 [ 12 ].…”