Clear Cell Adenocarcinoma Of Bladder Research Articles

Clear cell adenocarcinoma of urinary bladder in an area of endosalpingiosis (mullerianosis)

We present a case of a rare urinary bladder cancer. The patient was a 78-year-old lady who had a cystoscopy following an episode of macroscopic haematuria. Her endoscopic biopsy revealed a high-grade invasive carcinoma with clear cell differentiation. She underwent a radical cystectomy, which showed a clear cell adenocarcinoma (CCA) in an area of endosalpingiosis (Mullerianosis). Most bladder CCAs are not associated with Mullerianosis, have been diagnosed in patients with a previous history of urothelial carcinoma, and have an immunohistochemical profile overlapping that of usual urothelial carcinoma. They are thought to originate from glandular differentiation in urothelial neoplasms. Endosalpingiosis, fallopian tube epithelium outside the fallopian tube, is associated more with serous tumours than clear cell tumours. Although CCA of bladder has previously been called mesonephric carcinoma, there is no convincing evidence for a mesonephric origin. A Mullerian origin has been postulated [1-3] due to its female preponderance and morphological similarity to CCA of the female genital tract, which is often associated with benign Mullerian epithelium. This case supports the postulated Mullerian origin for CCA in bladder cancer.

Clear cell adenocarcinoma of the bladder and urethra

The clinical and pathological features of three hitherto unreported and 16 previously reported examples of clear cell adenocarcinoma of the urinary bladder and urethra are presented. Six tumors arose in the bladder and 13 in the urethra. Sixteen of the patients were female; they ranged in age from 35 to 78 years. The majority of the tumors were papillary but some were sessile. Microscopic examination revealed a variety of patterns, including tubular glands, cysts, papillae, and diffuse areas. Cells with abundant glycogen-rich clear cytoplasm and hobnail cells were identified in most of the tumors. These tumors must be distinguished from nephrogenic adenomas. A young age or a history of genitourinary trauma, operation, or calculous disease may be a clue to the latter diagnosis; microscopic features such as sheets of clear cells, significant pleomorphism, or mitotic activity favor the diagnosis of clear cell adenocarcinoma. Follow-up of most of the patients, the majority of whom were treated by a radical operation, was short; five tumors are known to have metastasized.