Case Of Urothelial Carcinoma Research Articles

Invasive Urothelial Carcinoma of the Bladder with Inverted Growth Pattern: A Case Report

Most urothelial neoplasms of the bladder present in an exophytic papillary form, but some present in an inverted growth form, in which case the invasive feature can be difficult to identify. We present a case of invasive urothelial carcinoma of the bladder associated with an inverted growth pattern, in which the patient underwent total cystoprostatectomy with ilio-obturator lymph node dissection and a Briker-type urinary diversion.

Case Report: Urothelial urethral carcinoma in HIV patient underwent total urethrectomy and perineal urethrostomy

Introduction HIV affects over 38 million people worldwide, affecting the immune system and leading to symptoms like fever, lymphadenopathy, and sore throat. High viral loads can lead to opportunistic infections and tumors. The life expectancy of HIV patients has increased due to high-efficiency combination anti-retroviral therapy. Urothelial carcinoma, a malignant development, damages the urinary canal lining. The connection between HIV and urinary cancers is unclear, the aims of this study to report a case of urethral urothelial Carcinoma in HIV patient who underwent total urethrectomy and perineal urethrostomy. Case presentation A 34-year-old male patient with a papilliferous lump on the glans penis for over six months was admitted to the hospital. Preoperative screening revealed HIV and a urethral mass was found. A partial urethrectomy was performed, revealing high grade papillary urothelial Carcinoma. Five months after surgery, the patient developed a recurrent lump, requiring a total urethrectomy, TUR (transurethral resection) of the mass in the prostatic urethra, and perineal urethrostomy. Conclusion Primary carcinoma of the urethra in HIV patient is an extremely rare case. To date, there is no consensus on the primary urethral carcinoma therapy. The treatment of primary urethral carcinoma is tailored specifically to the patient based on the location, histology, and stage of the carcinoma.

POU2F3-expressing intraepithelial small-cell carcinoma with mixed small-cell carcinoma and conventional-type urothelial carcinoma of the urinary bladder.

Based on lineage-specific transcription factors, small-cell neuroendocrine carcinoma (SmCC) of the urinary bladder has recently been subtyped into three molecular subtypes: ASCL1, NEUROD1 and POU2F3. The latter is a master transcriptional regulator of tuft cells (TCs) which are rare solitary cells found in various mucosal epithelia such as the gastrointestinal tract, but which have not been reported in the bladder. The POU2F3 subtype shows low or absent neuroendocrine marker expression. A case of mixed SmCC and conventional-type urothelial carcinoma (CUC) of the urinary bladder with POU2F3-expressing intraepithelial small-cell carcinoma in keeping with a tuft cell phenotype, arising in association with intestinal metaplasia (IM) is described. The presence of POU2F3-expressing cells in normal urothelium, cystitis cystica glandularis and IM of the urinary bladder is demonstrated in separate cases of cystitis cystica glandularis with IM. Also, POU2F3 expression is identified in a subset of bladder SmCC.

Massive renal pelvis urothelial carcinoma with invasion of the descending colon and cutaneous metastases: A case report and literature review

Introduction: Skin metastases and gastrointestinal tract involvement in upper tract urothelial carcinoma (UTUC) are uncommon and associated with an adverse prognosis. This report details a case of extensive urothelial carcinoma originating from the renal pelvis, invading the descending colon, and presenting with cutaneous metastases. Case Report: A 63-year-old male patient visited the emergency department on the account of sudden onset of severe left upper abdominal pain and nausea. The computed tomography (CT) revealed soft tissue density at the mesentery adjacent to the left kidney with the involvement of the distal transverse colon. The patient underwent left radical nephroureterectomy, left hemicolectomy, and bladder cuff excision. Six weeks postoperatively, left inguinal cutaneous metastases, approximately 4 cm, were excised. Due to renal dysfunction, the patient received gemcitabine and carboplatin chemotherapy, followed by pembrolizumab for the cutaneous metastatic disease. Follow-up imaging showed no evidence of recurrence or metastasis 15 months postoperatively. Conclusion: In cases of advanced UTUC, a multidisciplinary approach combining surgical intervention, chemotherapy, and immunotherapy can alleviate symptoms and potentially improve survival rates. This integrative treatment strategy highlights the importance of a multidisciplinary approach in managing complex oncological cases.

A case of bladder urothelial carcinoma that developed solitary metastasis to the left supraclavicular fossa lymph node after complete response to systemic chemotherapy

A case of bladder urothelial carcinoma that developed solitary metastasis to the left supraclavicular fossa lymph node after complete response to systemic chemotherapy

Pulmonary tumor embolism secondary to urothelial carcinoma of urinary bladder: case report and literature review

BackgroundTumor embolism is the least well-described cause of pulmonary embolism, taking into account the non-specificity of radiographic and nuclear imaging results, the necessity of anatomopathological evidence and the frequency of deep venous thrombosis in the course of solid tumors, suggesting thus thromboembolism.Case presentationWe report a rare case of urothelial carcinoma of the urinary bladder associated with persistent pulmonary embolism despite being on different anticoagulation regimens, the patient was ultimately found to have tumor thrombus in the pulmonary trunk secondary to tumoral extension. We provide a literature review as well about the diagnosis, evaluation and prognosis and of this rare clinical entity.ConclusionsOur case highlights the importance of keeping this unusual etiology in mind, particularly when faced with pulmonary embolism occurring in the context of a solid tumor and the ineffectiveness of various anticoagulation protocols. Furthermore, it emphasizes the pivotal role of cytology in confirming diagnosis and guiding therapy.

Invasive micropapillary urothelial carcinoma of the renal pelvis presenting as nonfunctional kidney: A unique presentation and review of the literature.

Micropapillary urothelial carcinoma of the renal pelvis is a rare and aggressive variant and poses a diagnostic challenge, especially related to the site and histomorphology of the tumor. A 60-year-old female presented with right pelvic-ureteric junction obstruction and a nonfunctioning right kidney. She underwent a simple right nephrectomy. The microscopy examination revealed a high-grade tumor of the renal pelvis, predominant micropapillary architecture. The tumor infiltrated into the kidney, renal sinus, perinephric fat, adrenal gland, and Gerota's fascia. Extensive lymphovascular and perineural invasions were also noted. On immunohistochemistry, tumor cells were positive for GATA-binding protein 3, cytokeratin 7, and cytokeratin 20, while negative for paired box gene 8, cluster of differentiation 10, mammaglobin, and alpha-methylacyl-CoA racemase. The p63 was positive in the conventional areas and negative in the micropapillary pattern. We reported an additional case of micropapillary urothelial carcinoma of the renal pelvis, literature review, and discussed the differential diagnosis. Immunonegativity of p63 in the micropapillary component was an additional finding.

A Case Report: High-Grade Urothelial Carcinoma in the Renal Pelvis with Complete Kidney and Ureter Duplication Featuring Heterologous Differentiation

This report describes a considerably rare case of high-grade urothelial carcinoma of the renal pelvis and ureter, presenting with heterologous differentiation, in a patient with bilateral duplicated kidneys. A 73-year-old male experienced intermittent gross hematuria for 5 months, accompanied by lower back and abdominal pain. Ultrasound and computed tomography scans revealed bilateral renal and ureteral duplication with multiple tumors in the left renal pelvis. A total nephroterectomy and bladder cuff resection were performed on the left two nephrons. Multiple space-occupying lesions were identified in the left renal pelvis and ureter. Histopathological examination showed poorly differentiated and diverse tumor cells, manifesting as sarcomatoid carcinoma, papillary adenocarcinoma, and infiltrating high-grade urothelial carcinoma. The tumor infiltrated the subcutaneous fibrous connective tissue of the renal pelvis and the full thickness of the ureter. Given the rarity of recurrent renal urothelial carcinoma with heterogeneous differentiation, comprehensive imaging and pathological assessments are vital to delineate the nature of the lesion and the direction of tissue pathological heterologous differentiation. These evaluations guide early radical surgical interventions, improving survival rates.

A case of bladder urothelial carcinoma nested variant with invasion to the rectum treated with surgery and intraoperative radiotherapy.

A case of bladder urothelial carcinoma nested variant with invasion to the rectum treated with surgery and intraoperative radiotherapy.

The preliminary efficacy of "quadri-combination" therapy on the treatment of bladder cancer

To investigate the safety and efficacy of "quadri-combination" therapy including maximal transurethral resection of bladder tumor (mTURBT), combined with systemic chemotherapy and immunotherapy, concurrent radiotherapy, and immune maintenance therapy. The clinical data of 8 patients with bladder cancer who could not tolerate or refused radical cystectomy at the Department of Urology, Peking University Cancer Hospital from November 2019 to October 2021 were retrospectively analyzed. There were 5 males and 3 females with a mean age of 69 years. The Eastern Cooperative Oncology Group(ECOG) score was 0 in 6 cases and 1 in 2 cases. There were 5 cases of high-grade urothelial carcinoma (1 case of T3b; 2 cases were T2; 2 cases of T1 stage, with multiple tumors and repeated recurrence), 1 case of high-grade urothelial carcinoma with carcinoma in situ (T1/Tis stage), 1 case of high-grade urothelial carcinoma with squamous differentiation (T3b stage), and 1 case of high-grade urothelial carcinoma with glandular differentiation (T2). All patients underwent "quadri-combination" therapy.The patient's tolerance, success rate of bladder preservation and prognosis were evaluated.The median follow-up time was 22.5 (12-35) months. One patient with high-grade muscle-invasive bladder cancer (T2) received mTURBT, albumin-bound paclitaxel and durvalumab combined therapy for 3 cycles, concurrent radiotherapy, and immune maintenance therapy for 18 months, and the tumor recurrence was found. The pathology was high-grade urothelial carcinoma. Salvage radical cystectomy combined with pelvic lymph node dissection is recommended. The remaining 7 patients were regularly reexamined, and no recurrence or metastasis was found.The 2-year progression-free survival rate was 80%, and the success rate of bladder preservation was 87.5%(7/8). Treatment-related adverse reactions were resolved by symptomatic treatment, and patients' compliance and tolerance were acceptable.The "quadri-combination" bladder-preserving therapy is feasible and well tolerated, but further studies are needed.

A canine case of bladder urothelial carcinoma (transitional cell carcinoma) treated with a chemotherapeutic agent, a molecular targeted drug, and cyclooxygenase inhibitors

A 4-year-old neutered male Scottish Terrier, weighing 10.4 kg, presented with hematuria for the past 10 days. Ultrasonography revealed multiple masses in the apex and trigone of the bladder. A catheter biopsy was performed, and the histopathological diagnosis was non-invasive urothelial carcinoma (transitional cell carcinoma) with low to medium grade pathological malignancy. Treatments with piroxicam alone, vinblastine and firocoxib, toceranib and firocoxib, and firocoxib alone resulted in a partial response or stable disease. The patient showed no regional lymph node metastasis or distant metastases, maintained stable disease, and had an excellent quality of life at 1681 days after the start of treatment.

A case of papillary and infiltrative urothelial carcinoma of the urinary bladder in a terrier dog

Urothelial carcinomas are malignant tumours originating from the epithelial layer of the urinary bladder. In this instance, a case of papillary and infiltrative urothelial carcinoma in the urinary bladder of a 2-year-old terrier dog was defined clinically, histopathologically and immunohistochemically. The material of the presented case consisted of urinary bladder tissue samples that were surgically extirpated from a two-year-old terrier-breed female dog that applied to the Department of Surgery of the Faculty of Veterinary Medicine, Selcuk University with the complaint of hematuria. The tumour brought to the pathology laboratory was 11*10*12 cm in size and had finger-shaped extensions. Its outer surface was rough and hemorrhagic. Tissues were fixed in 10% buffered formalin and paraffin blocks were obtained by going through the necessary routine follow-up procedures. Afterward, sections were taken and subjected to Hematoxylin-Eosin, Masson's Trichrome, and immunohistochemical staining. As a result of the pathological and immunohistochemical examinations of the tumoral tissue samples taken from the urinary bladder, the diagnosis of papillary and infiltrative urothelial carcinoma was reached, and the case was discussed with the information provided by the literature. In addition, immunohistochemically, intense Proliferating cell nuclear antigen (PCNA) and Vascular endothelial growth factor (VEGF) staining has been associated with malignancy.

TRPS1 expression is sensitive and specific for primary extramammary Paget disease.

Extramammary Paget disease (EMPD) is an epithelial neoplasm that can occur at many sites, including the vulva and scrotum. EMPD is characterised by the presence of neoplastic cells, in single cells and clusters, that infiltrate all layers of non-neoplastic squamous epithelium. The differential diagnosis for EMPD includes melanoma in situ and secondary involvement of tumours from other sites, such as urothelial or cervical; pagetoid spread of tumor cells can also been seen at other sites, such as anorectal mucosa. The most frequently utilised biomarkers for confirming the diagnosis of EMPD include CK7 and GATA3; however, these biomarkers lack specificity. The purpose of this study was to evaluate TRPS1, a newly described breast biomarker, in pagetoid neoplasms of the vulva, scrotum and anorectum. Fifteen cases of primary EMPD of the vulva (two with associated invasive carcinoma) and four primary EMPD of the scrotum showed strong nuclear immunoreactivity for TRPS1. In contrast, five cases of vulvar melanoma in situ, one case of urothelial carcinoma with secondary pagetoid spread into the vulva and two anorectal adenocarcinomas with pagetoid spread into anal skin (one with associated invasive carcinoma) were negative for TRPS1. Additionally, weak nuclear TRPS1 staining was observed in non-neoplastic tissues (e.g. keratinocytes), but always with less intensity when compared to tumour cells. These results demonstrate that TRPS1 is a sensitive and specific biomarker for EMPD, and may be especially useful for excluding secondary involvement of the vulva by urothelial and anorectal carcinomas.

Sarcomatoid urothelial carcinoma of the renal pelvis treated with immunotherapy

BackgroundSarcomatoid carcinoma is a rare, high-grade malignancy with epithelial and mesenchymal components. It may be a good candidate for immunotherapy because it is associated with overexpression of programmed cell death ligand 1. Sarcomatoid urothelial carcinoma (UC) of the upper urinary tract is extremely rare. Here we report the first case of sarcomatoid UC of the renal pelvis that responded to immunotherapy.Case presentationA 79-year-old man was referred to our hospital complaining of various symptoms, including anorexia and abdominal pain. A computed tomography scan revealed a right atrial tumor, a 9 cm left renal mass with a renal vein tumor thrombus, para-aortic lymphadenopathy, and multiple small lung nodules. The patient underwent resection of the right atrial tumor. Pathological analysis of the tumor did not lead to an accurate diagnosis even after several rounds of immunohistochemistry. He underwent a needle biopsy of the left kidney and was initially diagnosed with collecting duct carcinoma, a rare subtype of renal cell carcinoma (RCC). Following the initial diagnosis, immunotherapy with nivolumab and ipilimumab commenced. Thereafter, almost all lesions, including the left renal tumor, were reduced in size. However, he underwent a left nephrectomy approximately a year after beginning immunotherapy due to repeated left renal bleeding. Histological examination of the nephrectomy specimen revealed two forms of cancer—sarcomatoid UC and conventional high-grade UC. Two months after surgery, the patient was found to have new lung metastases. He underwent chemotherapy with gemcitabine and cisplatin, followed by immunotherapy with pembrolizumab. However, both treatments were ineffective. The patient died of cancer 19 months after his first admission.ConclusionsThe presented case of sarcomatoid UC of the renal pelvis that partially responded to immunotherapy suggests that immunotherapy can be a promising treatment for sarcomatoid UC.

Single lung metastasis of urothelial carcinoma can be cured by surgical resection with long-term survival

Introduction: Metastatic urothelial carcinoma is unlikely to be cured. Case Report: We present a case of urothelial carcinoma (UC) with lung metastasis which was cured after resection. A 57-year-old male who was found to have a mass in the right renal pelvis involving the right ureter and urinary bladder. Biopsies from the renal mass and the bladder showed papillary UC with no invasion to the lamina propria (pTa). He underwent a right radical nephroureterectomy, pelvic lymphadenectomy, and cystoprostatectomy with ileal loop conduit urinary diversion. A growing metastatic mass in the upper lobe of the left lung was found five years later. It was resected. On follow-up, he has no evidence of metastasis four years after surgery. Conclusion: Pulmonary metastasis from urothelial origin can have cavitary appearance on computed tomography (CT) and can happen after more than five years of primary tumor resection. Long-term follow-up is necessary for detection of late metastasis that can be resected if solitary pulmonary with possible long-term survival.

A case of invasive urothelial carcinoma

A case of invasive urothelial carcinoma

An Unusual Case of Urothelial Carcinoma of Bladder with Metastasis to Brain and Skeletal Muscles Evaluated on 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography.

Urothelial or transitional cell carcinoma is the most prevalent variant of urinary bladder carcinoma worldwide occurring in both men and women. There are a very few cases described in the literature with metastasis to skeletal muscles and even fewer cases with metastatic site in the brain. We present a case of high-grade urothelial carcinoma with metastasis to the left temporal lobe as well as multiple inter- and intra-muscular deposits in the left thigh.

Urothelial Cell Carcinoma with Squamous Differentiation of the Bladder in Association with Intermittent Self-Catheterization

Intermittent self-catheterization was introduced as an alternative to reduce the risk of developing cancers of the bladder in patients with indwelling catheters. Since then, case studies have shown that the risk is not entirely mitigated. Squamous cell carcinoma of the bladder and urothelial cell carcinoma with squamous differentiation are rarely reported as consequence of ISC. As such, these diagnoses are not generally considered as risks and alarm symptoms are often disregarded. We report a case of urothelial cell carcinoma with squamous differentiation as a result of decades of ISC.

Urothelial Carcinoma with Rhabdoid Features

The histo-morphological spectrum of variant transitional cell carcinoma (TCC) types has a wide range of different impacts on both thearapeutic approaches and clinical outcomes when compared to the TCC without variant pathology. TCC with rhabdoid features is rarely encountered and has been reported in only handful of cases. Herein we report a case of urothelial carcinoma with rhabdoid features originating from the upper urinary tract.

A surgical case of high-grade urothelial carcinoma of the renal pelvis complicated with giant hydronephrosis, giving rise to diagnostic difficulties on a cytological examination

BackgroundWe report a surgical case of urothelial carcinoma of the renal pelvis, resulting in diagnostic difficulties on cytological examination.Case presentationA man in his late 70s underwent nephrectomy for giant hydronephrosis and renal cysts after nephrostomy and renal cyst puncture and drainage. On all cytological examinations performed before surgery, including nephrostomy urine, renal cyst fluid, catheterized bladder urine, and bladder washings, we were unable to make any conclusive diagnosis of malignancy. The pathological diagnosis of the surgical specimen concluded that this was a case of high-grade urothelial carcinoma of the renal pelvis with focal squamous differentiation (pT4). Liver and lung metastases were identified 3 months after surgery, and the patient died 2 months later.ConclusionIt was very difficult to make a conclusive diagnosis using cytological specimens because of the presence of a small number of atypical cells with severe degenerative changes. Since clinicians cannot predict the potential for malignancy on preoperative imaging findings, it is critical to consider the difficulties in clinically making a correct diagnosis of urothelial carcinoma of the upper urinary tract, especially in cases complicated with giant hydronephrosis.