Primary Adenocarcinoma of the Urinary Bladder – Clinical and Pathological analysis of 25 Cases

Abstract

Primary addenocarinoma of the urinary bladder is a rare tumor, accounting for only to 2.0%of all bladder tumors. It is divided into urachal and non-urachal tumors according to its pathogenesis. The clinical course and pathological features of 25 patients with non-urachal adenocarcinoma of the bladder were analysed retrospectively. Four cases of adenocarcinomas were admixed with transitional cell carcinoma. The remaining 21 cases were pure adenocarcinoma. However, those cases showed a single histologic pattern or combination of subtypes: glandular, papillary, colloid, signet ring cell or clear cell type. Neither the location nor the histologic appearance of the tumor was correlated with prognosis, though, the tumor stage is one of the most significant predictors for prognosis. The five-year survival rate for Stages A、B、C and D were 100%、28%、12% and 0%, respectively. Four patients (16%) had local recurrence recurrence after radical or partial cystectomy. In these four case, two recurrent tumors were composed of transitional cell carcinoma or squamous cell carcinoma. The locations of distant metastasis include lung (54%)、bone (36%) and liver (18%). It was concluded that radical or partical cystectomy cases have a better survival time than using radiotherapy or transurethral resection, which provide only the symptomatic relief.