Primary Bladder Adenocarcinoma Research Articles

Primary signet-ring cell carcinoma of the bladder treated with laparoscopic radical cystectomy: a case report.

Primary bladder adenocarcinomas comprise 0.5-2% of all epithelial bladder neoplasms. Of these, primary signet-ring cell carcinoma of the bladder is particularly rare, accounting for 0.24% of all bladder malignancies. This tumor is frequently diagnosed at an advanced stage and has a poor prognosis. No standard treatment has yet been established. We here report a patient in whom laparoscopic cystectomy following neoadjuvant chemotherapy was effective. Our patient was a 69-year-old man who had had microscopic hematuria, undergone transurethral resection of a mass in the bladder, and been diagnosed pathologically with a primary signet-ring cell carcinoma of the bladder. No metastases were detected on computed tomography. The patient was treated with a combination of paclitaxel, cisplatin, and gemcitabine prior to undergoing laparoscopic cystectomy. The histopathological diagnosis on this operative specimen was dysplasia and no metastases were detected in the dissected lymph nodes. Complete remission has now been maintained for 9years.

Mutational signature and prognosis in adenocarcinoma of bladder.

655 Background: Adenocarcinoma of bladder is a rare urinary bladder carcinoma with limited therapy options due to lack of molecular characterization. Here we aim to reveal mutational and transcriptomic landscapes of adenocarcinoma of bladder and their relationship with prognosis. Methods: Between February 2015 and June 2021, a total of 23 patients with adenocarcinoma of bladder were included. These included 16 patients with primary bladder adenocarcinomas and 7 patients with urachal adenocarcinoma. Whole exome sequencing, whole genome sequencing, bulk RNA-Seq and single-cell RNA-Seq were conducted for the specimens. Correlation analysis, survival analysis and t tests were also performed. Results: Prevalent T>A substitutions were observed among somatic mutations, and major tri-nucleotide contexts included 5′-CTC-3′and 5′-CTG-3′. This pattern was mainly contributed by COSMIC Signature 22 related to chemical carcinogen exposure (probably aristolochic acid), which has not been reported in bladder adenocarcinoma. Moreover, genes with copy number changes also enriched KEGG term “chemical carcinogenesis”. Transcriptomic analysis implied high immune infiltration and luminal-like feature in majority of samples. Interestingly, a small fraction of samples with APOBEC-derived mutational signature exhibited higher risk of disease progression compared with samples with only chemical carcinogen-related signature, confirming molecular and prognosis heterogeneity in bladder adenocarcinoma. Conclusions: This study presents mutational and transcriptomic landscapes of bladder adenocarcinoma, and chemical carcinogen-related mutational signature indicates good prognosis in adenocarcinoma of bladder.

Mutational signature and prognosis in adenocarcinoma of the bladder.

Adenocarcinoma of the bladder is a rare urinary bladder carcinoma with limited therapy options due to lack of molecular characterization. Here, we aimed to reveal the mutational and transcriptomic landscapes of adenocarcinoma of the bladder and assess any relationship with prognosis. Between February 2015 and June 2021, a total of 23 patients with adenocarcinoma of the bladder were enrolled. These included 16 patients with primary bladder adenocarcinomas and seven patients with urachal adenocarcinoma. Whole exome sequencing (16 patients), whole genome sequencing (16 patients), bulk RNA sequencing (RNA-seq) (19 patients), and single-cell RNA-seq (5 patients) were conducted for the specimens. Correlation analysis, survival analysis, and t-tests were also performed. Prevalent T>A substitutions were observed among somatic mutations, and major trinucleotide contexts included 5'-CTC-3' and 5'-CTG-3'. This pattern was mainly contributed by COSMIC signature 22 related to chemical carcinogen exposure (probably aristolochic acid), which has not been reported in bladder adenocarcinoma. Moreover, genes with copy number changes were also enriched in the KEGG term 'chemical carcinogenesis'. Transcriptomic analysis suggested high immune cell infiltration and luminal-like features in the majority of samples. Interestingly, a small fraction of samples with an APOBEC-derived mutational signature exhibited a higher risk of disease progression compared with samples with only a chemical carcinogen-related signature, confirming the molecular and prognostic heterogeneity of bladder adenocarcinoma. This study presents mutational and transcriptomic landscapes of bladder adenocarcinoma, and indicates that a chemical carcinogen-related mutational signature may be related to a better prognosis compared with an APOBEC signature in adenocarcinoma of the bladder. © 2024 The Pathological Society of Great Britain and Ireland.

Regular gastroscopy and colonoscopy during the evaluation of urachal cancer: do we really need them?

PurposeUrachal cancer is similar to gastrointestinal adenocarcinoma in histology, and gastroscopy/colonoscopy is often administered during perioperative evaluation. However, gastroscopy and colonoscopy have corresponding disadvantages. This study discusses whether gastroscopy/colonoscopy is truly necessary for patients with urachal cancer.Patients and methodsA total of 166 bladder adenocarcinoma cases diagnosed at Sun Yat-sen University Cancer Center were retrospectively reviewed and divided into two groups (urachal cancer and nonurachal cancer), and perioperative evaluations were retrieved.ResultsThere were 78 patients with urachal cancer, the median age was 48 years, and 59 were male. Perioperative gastroscopy/colonoscopy revealed 5 intestinal polyps and 1 adenoma during these evaluations, and no primary gastrointestinal cancer was found. Meanwhile, preoperative imaging evaluation did not detect significant gastrointestinal lesions. For 88 patients with nonurachal cancer, including primary bladder adenocarcinoma and metastatic tumors from gastrointestinal cancer, the median age was 56 years, and 64 were male. Preoperative imaging evaluation demonstrated 36 cases of gastrointestinal lesions, and 32 were confirmed by gastroscopy/colonoscopy; the other 4 were negative. Another 4 cases of colon cancer were detected by regular colonoscopy for suspected primary bladder adenocarcinoma. In all, 35 cases of colon cancer and 1 case of gastric cancer were identified by endoscopic examination. The diagnostic consistency of imaging and gastrointestinal endoscopy was favorable (P < 0.001), and the negative predictive value and diagnostic efficiency of imaging were 96.9% and 94.6%, respectively.ConclusionsThe vast majority of gastrointestinal cancer cases can be identified by assessment of the patient’s clinical symptoms, meticulous physical examination, and imaging evaluation. We recommend that gastroscopy/colonoscopy only be applied to patients with urachal cancer when the above examinations are positive.

Primary Signet Ring Cell Mucinous Adenocarcinoma of the Urinary Bladder: A Rare Case Report

Primary ‘signet ring mucinous adenocarcinoma’ is most commonly located in the stomach. The bladder is an uncommon presentation site for the primary location of this tumor. Mucinous signet-ring adenocarcinoma with urinary bladder as the primary origin is uncommon, accounting for fewer than two percent of all upper urinary tract carcinomas. The presence of signet ring cells, which is caused by compression and displaced nucleus of the cell into a crescent placed in the periphery along the cell wall, is a distinguishing feature of signet ring cell carcinoma. These cells are loaded with cytoplasmic mucus-containing vacuoles. Lower than one-third of primary bladder signet ring cell carcinoma cases show this gross morphology showing linitis plastica pattern with subepithelial infiltration without producing an exophytic mass in a pure signet ring cell carcinoma. Because this tumor shares histological features with the adenocarcinomas originating in several other sites, such as the prostate, digestive tract, and reproductive system, immunohistochemistry tests are required to confirm the bladder as the primary origin. Owing to the paucity of the neoplasm and the difficulty in locating the underlying tumor, site identification is frequently prolonged, leaving palliative care as the only choice for roughly half of the patients. This study depicts a rare case report of primary vesicular signet ring cell mucinous adenocarcinoma that considerably invades the pelvis and retroperitoneum's prostate and lymph nodes. This case emphasizes the significant characteristics of bladder mucinous adenocarcinoma, such as the sequence of tumor spread, the propensity for preliminary diagnostic errors, the microscopic pattern, and the significance of immunohistochemistry for defining its primary root from the bladder and selecting the most suitable intervention from the start.

Urachal carcinoma: The journey so far and the road ahead.

Urachal carcinoma, a rare cancer arising from urachus, accounts for about 1% of bladder cancer. The diagnosis at stage I shows about 63% 5-year survival whereas only 8% of the patients at stage IV shows a 5-year survival. Above 90% of urachal carcinomas are adenocarcinomas and most of the urachal carcinoma cases are invasive, showing a high resemblance to adenocarcinoma of various origins, making it hard for a conclusive diagnosis. Even though inconclusive, immunohistochemistry can play a significant role in identifying urachal carcinoma. Most cases show the biomarkers CK20 and CDX2, whereas CK7 and β-catenin are expressed at a lesser frequency. Due to the few cases available, there is a lack of evidence regarding specific markers differentiating urachal carcinoma from colorectal or primary bladder adenocarcinomas. In addition to immunohistochemistry, genomic characterization is emerging to play a role in the classification and treatment of the disease. Urachal carcinoma has been reported to have a molecular level similarity with colorectal malignancies regarding certain gene expressions. The TP53 mutations inactivating the tumor suppressor can probably be explored as a possible target in treating urachal carcinoma. Additionally, certain targets identified in gastric and breast cancer along with anti-HER2 treatment strategies can be explored. Immuno-oncology utilizes immune checkpoint inhibitors for the treatment of MSI-H tumors whereas a combination of tyrosine kinase inhibitors along with immune checkpoint inhibitors are being studied to treat MSI stable tumors. The article is an in-depth overview of urachal carcinoma addressing the current landscape with an emphasis on the future scenario.

Clinical sequencing identifies potential actionable alterations in a high rate of urachal and primary bladder adenocarcinomas.

Administration of targeted therapies provides a promising treatment strategy for urachal adenocarcinoma (UrC) or primary bladder adenocarcinoma (PBAC); however, the selection of appropriate drugs remains difficult. Here, we aimed to establish a routine compatible methodological pipeline for the identification of the most important therapeutic targets and potentially effective drugs for UrC and PBAC. Next-generation sequencing, using a 161 cancer driver gene panel, was performed on 41 UrC and 13 PBAC samples. Clinically relevant alterations were filtered, and therapeutic interpretation was performed by in silico evaluation of drug-gene interactions. After data processing, 45/54 samples passed the quality control. Sequencing analysis revealed 191 pathogenic mutations in 68 genes. The most frequent gain-of-function mutations in UrC were found in KRAS (33%), and MYC (15%), while in PBAC KRAS (25%), MYC (25%), FLT3 (17%) and TERT (17%) were recurrently affected. The most frequently affected pathways were the cell cycle regulation, and the DNA damage control pathway. Actionable mutations with at least one available approved drug were identified in 31/33 (94%) UrC and 8/12 (67%) PBAC patients. In this study, we developed a data-processing pipeline for the detection and therapeutic interpretation of genetic alterations in two rare cancers. Our analyses revealed actionable mutations in a high rate of cases, suggesting that this approach is a potentially feasible strategy for both UrC and PBAC treatments.

Synchronous Primary Adenocarcinoma of Distal Common Bile Duct and Gall bladder.

Synchronous primary cancer of the gall bladder and distal common bile duct is rare. There are only few case reports and case series available of these synchronous cancers. Management of this tumor is individualized in these case reports and series based upon the presentation. We present a case of a patient who had multifocal adenocarcinoma involving distal common bile duct and gall bladder. Keywords: Distal common bile duct cancer; gall bladder cancer; synchronous primary.

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

Primary mucinous adenocarcinoma of the urinary bladder is a rare malignancy and accounts for less than 2 % of all malignant urinary bladder tumors. This malignancy occurs more commonly in males, with a peak incidence in the sixth decade of life. Herein, we report a case of a 29-year-old male presenting with pain in the symphysis pubis, urinary frequency, and haematuria. Clinical, laboratory, and radiology findings lead to suspicion of urinary bladder malignancy with bilateral hydronephrosis and chronic kidney disease.

Survival of Patients With UrAC and Primary BAC and Urothelial Carcinoma With Glandular Differentiation.

PurposeTo investigate the significance of demographic and pathological characteristics on the survival outcomes of urachal adenocarcinoma (UrAC), primary bladder adenocarcinoma (BAC) and urothelial carcinoma with glandular differentiation (UCGD) in China.Materials and MethodsWe retrospectively analyzed cases with non-distant metastases (≤ T4M0). Of 106 patients, 30 (28.3%), 40 (37.7%), and 36 (34.0%) met the criteria for UrAC, primary BAC, and UCGD, respectively. Data on patient demographics, tumor pathology, and survival outcomes were collected. The median follow-up was 36 months. Survival was analyzed using multivariate Cox regression.ResultsPatients with UrAC were younger (51.87 ± 15.25 years) than those with primary BAC (60.50 ± 12.56 years) and UCGD (63.83 ± 11.60 years) (P<0.001). Patients with UrAC were the most likely to be stage T3–4 (70.0% vs. 40.0% vs. 44.4%; P<0.001), while the primary BAC group had a higher rate of poor differentiation than the UrAC and UCGD groups (57.4% vs. 18.5% vs. 24.1%; P<0.001). The Kaplan–Meier curves showed that the overall survival (OS), progression-free survival (PFS), and disease-specific survival (DSS) of the primary BAC group were poorer than those of both the UrAC and UCGD groups (P=0.0046,P<0.0001,P=0.0077 respectively). Regarding BAC, patients with mucinous adenocarcinoma tended to have better OS and PFS than those with other histological types (P<0.005,P=0.0245). Multivariate Cox regression analysis revealed that tumor type (P=0.002), T stage (P=0.034), and the age-adjusted Charlson Comorbidity Index (aCCI) scores (P=0.005) predicted the postoperative OS and DSS of the patients. For PFS, the tumor type (P=0.011), grade (P=0.000), and aCCI (P=0.002) scores were predictive.ConclusionAmong UrAC, primary BAC, and UCGD patients, the prognosis was poorest for those with primary BAC. Attempts should be made to diagnose these aggressive tumors early, since patients in whom tumors are detected early appear to survive longer.

Primary Bladder Adenocarcinoma: A Case Report

Primary bladder adenocarcinoma (PBA) is rarely seen in the clinical setting at present. Bladder adenocarcinoma has a special biological behavior, as well as high invasive and metastatic potential. In addition, it is very difficult to diagnose PBA at an early stage. Having similar clinical manifestation to urothelial carcinoma and metastatic adenocarcinoma of the bladder, the differential identification and diagnosis have become more complicated. A majority of adenocarcinoma is not sensitive to radiation and chemotherapy, and thus, the prognosis of PBA is generally poorer. Currently, surgery serves as the principal mode of treatment. In this case report, we had observed a PBA case for 1.5 years, and no recurrence and metastasis had been reported.

Primary urinary bladder adenocarcinoma with vaginal invasion

Primary urinary bladder adenocarcinoma is not a common tumor, it comprises between 0.5 and 2% of all bladder tumors. It has been linked to bladder exstrophy, chronic irritation, and pelvic lipomatosis. Next, the case of a 62-year-old female patient with primary urinary bladder adenocarcinoma and vaginal wall invasion is presented.

Primary Signet-ring Cell Adenocarcinoma of the Urinary Bladder That Invades the Pelvic Wall Treated with Partial Cystectomy and Adjuvant Chemotherapy: A Case Report and Review of the Literature

Primary Signet-ring Cell Adenocarcinoma of the Urinary Bladder That Invades the Pelvic Wall Treated with Partial Cystectomy and Adjuvant Chemotherapy: A Case Report and Review of the Literature

Role of adjuvant chemotherapy in the treatment of patients with node-positive bladder adenocarcinoma: An analysis of the National Cancer Database.

e16504 Background: Given the rarity of bladder adenocarcinoma, there is a paucity of data examining the role of adjuvant chemotherapy (AC) in patients with regional lymph node positivity. This study aims to elucidate the oncologic and survival outcomes of patients with node-positive disease treated with or without AC. Methods: A retrospective cohort analysis of patients with node-positive primary bladder adenocarcinoma who had either received AC or did not receive AC after either radical (RC) or partial cystectomy (PC) was performed using the National Cancer Database from 2006 to 2016. Non-metastatic node-positive was defined as pT(any)N1-3 (pN+) disease. Demographic and clinicopathological variables were compared to adjust for confounding covariates in multivariable analysis to determine appropriate oncologic and surgical outcomes. Results: A total of 106 patients met inclusion criteria, of whom 38 received AC and 68 did not. Receipt of AC was significantly associated with improved survival relative to those who did not receive AC (overall survival: 29% vs 2.7%; adjusted hazards ratio = 0.43; p = 0.003) independent of extent of surgery. There was a trend toward higher receipt of adjuvant radiation along with AC, independent of surgical margin status. Receipt of AC additionally trended towards a significant association with decreased odds of 90-day mortality and 30-day unplanned readmission (Table). Conclusions: Based on the improved survival outcomes, positive nodal status may be a useful indicator of those who may benefit from AC, and potentially adjuvant radiation therapy, in bladder adenocarcinoma. Though compelling, larger studies will be required to make more conclusive statements regarding the most appropriate treatment course in these patients.[Table: see text]

Telomerase reverse transcriptase (TERT) promoter mutations in primary adenocarcinoma of bladder and urothelial carcinoma with glandular differentiation: pathogenesis and diagnostic implications.

Telomerase reverse transcriptase (TERT) promoter mutations have been implicated in urothelial carcinogenesis and are present in 60-80% of conventional and variants of urothelial carcinomas. We investigated the prevalence of TERT promoter mutations in 46 cases of bladder nonurachal adenocarcinoma, 30 cases of urothelial carcinoma with glandular differentiation, 24 cases of nephrogenic adenoma, eight cases of villous adenoma, 31 cases of florid cystitis glandularis, and 20 cases of intestinal metaplasia of the bladder. TERT promoter mutations were detected in 33% of adenocarcinomas of urinary bladder and in 67% of urothelial carcinomas with glandular differentiation. All 30 cases of urothelial carcinoma with glandular differentiation harbored identical TERT promoter mutation in both glandular and urothelial carcinoma components from the same tumor, suggesting a common clonal origin. TERT promoter mutations were absent in nephrogenic adenoma, villous adenoma, florid cystitis glandularis, and intestinal metaplasia of the bladder. TERT promoter mutation analysis may be a useful ancillary study in the differential diagnosis.

The impact of adjuvant chemotherapy on oncologic outcomes of patients with locally advanced bladder adenocarcinoma: An analysis of the National Cancer Database.

495 Background: The relatively poor prognosis associated with locally advanced bladder adenocarcinoma necessitates investigation of the utility of adjuvant chemotherapy (AC) and risk stratification of those who would benefit from such systemic therapy. This study seeks to evaluate the oncologic and surgical outcomes of those with locally advanced disease treated with and without AC. Methods: A retrospective cohort analysis was performed using the National Cancer Database from 2006 to 2016. Patients with non-metastatic locally advanced pT3-4 or pT(any)N1-3 primary bladder adenocarcinoma who received AC only or did not receive AC after radical (RC) or partial cystectomy (PC) were included. The AC cohort was further sub-stratified by surgery type (PC versus RC) and disease origin (urachal versus non-urachal subtypes). Survival, oncologic, and surgical outcomes were compared between cohorts. Results: Inclusion criteria identified 79 AC patients and 251 no AC patients. Of the 79 patients who received AC, 23 had PC procedure, 56 had RC procedure, 10 had urachal origin and 69 had non-urachal origin. Receipt of AC was significantly higher in RC relative to PC (27.6% vs 18.1%; p = 0.049). Urachal vs. non-urachal subtype did not impact receipt of AC (25.3% vs 17.5%; p = 0.214), but urachal subtype was associated with improved overall survival compared to non-urachal (47% vs 18%; HR = 0.37; p = 0.04). Although receipt of AC was significantly associated with higher odds of positive margins (46% vs 23%; odds ratio = 2.85; p &lt; 0.01), no difference in overall survival was detected between the AC and no AC cohorts (23% vs 19%; hazards ratio [HR] = 0.98; p = 0.91). Of note, independent of AC, PC was associated with improved survival compared to RC (51% vs 12%; HR = 0.25; p &lt; 0.01). Conclusions: There is no detected survival benefit to the use of a non-standardized AC regimen in locally advanced bladder adenocarcinoma. Within the AC treated population, survival outcomes suggest that urachal subtype may confer survival advantage and that those patients selected for PC tend to have improved survival. Although employing a national dataset, statistical power was limited given the rarity of this disease. Further investigation is warranted on a larger scale in order to assess the impact of AC regimen, afford proper patient selection, and enhance risk stratification for oncologic outcomes.

Carcinomas in the bladder with papillary and pseudopapillary morphology - not always urothelial

BackgroundUrothelial carcinoma shows wide plasticity and broad morphologic spectrum. In many instances, the presence of papillary morphology is reassuring of the urothelial histogenesis of a high-grade invasive lesion but is not pathognomonic.Case presentationWe reported herein four cases of carcinomas in the bladder with papillary morphology that had a final diagnosis different from urothelial carcinoma (3% of cases in a 42-month period). In high-grade tumors involving the urinary tract, the presence of papillary/pseudopapillary morphology is not sufficient to render a diagnosis of papillary urothelial carcinoma. Prostate adenocarcinoma, primary bladder adenocarcinoma or metastasis must be excluded in selected case scenarios.

Molecular Genetic Features of Primary Nonurachal Enteric-type Adenocarcinoma, Urachal Adenocarcinoma, Mucinous Adenocarcinoma, and Intestinal Metaplasia/Adenoma: Review of the Literature and Next-generation Sequencing Study

The diagnosis of primary adenocarcinoma of the urinary bladder may be challenging in routine practice. These tumors may morphologically and immunohistochemically overlap with urachal adenocarcinoma and colorectal adenocarcinoma. Further, their genetic background is poorly understood. We systematically searched the PubMed database for results of complex genetic evaluation of primary bladder adenocarcinoma subtypes. Subsequently, we designed our own series of bladder lesions. We evaluated 36 cases: 16 primary enteric-type adenocarcinomas, 7 urachal enteric adenocarcinomas, 3 primary mucinous/colloid adenocarcinomas, and 10 intestinal-type metaplasia/villous adenoma. Detailed clinical data were collected, and all cases were examined using targeted next-generation sequencing. On the basis of the literature, the first mutated gene in these tumors was reported to be KRAS in 11.3% of cases, followed by TERT promoter mutations in 28.5%. In addition to KRAS and TERT, other genes were also found to be frequently mutated in primary bladder adenocarcinoma, including TP53, PIK3CA, CTNNB1, APC, FBXW7, IDH2, and RB1. In our series, the most frequent gene mutations in primary enteric-type adenocarcinomas were as follows: TP53 (56%); BRCA2, KMT2B (both 33%); NOTCH2, KDR, ARID1B, POLE, PTEN, KRAS (all 28%); in urachal enteric adenocarcinoma they were as follows: TP53 (86%); PTEN, NOTCH (both 43%); in primary mucinous/colloid adenocarcinomas they were as follows: KRAS, GRIN2A, AURKB (all 67%); and, in intestinal-type metaplasia/villous adenoma, they were as follows: APC, PRKDC (both 60%); ROS1, ATM, KMT2D (all 50%). No specific mutational pattern was identified using cluster analysis for any of the groups. Herein, we describe the pathologic features and immunohistochemical staining patterns traditionally used in the differential diagnoses of glandular lesions of the bladder in routine surgical pathology. We outline the mutational landscape of these lesions as an aggregate of published data with additional data from our cohort. Although diagnostically not discriminatory, we document that the most common genetic alterations shared between these glandular neoplasms include TP53, APC (in the Wnt pathway), and KRAS (in the MAPK pathway) mutations.

MUCINOUS ADENOCARCINOMA OF GALL BLADDER: A RARE ENTITY IN GALL BALDDER ADENOCARCINOMA

Gall bladder carcinoma is the most common type of tumor of the biliary tract and adenocarcinoma is the major histopathological subtype. Mucinous variant is a rare subtype and mucinous carcinoma accompanied with signet ring is extremely rare. When mucinous component exceeds 90% of the tumor, it is labeled as pure mucinous carcinoma. Immunohistochemistry helps to distinguish primary mucinous adenocarcinoma of gall bladder from pseudo myxoma peritonei from appendiceal neoplasm. Mucinous carcinoma is CK 7 positive and CK20 negative. We report a case of mucinous adenocarcinoma arising from the fundus of the gall bladder.&#x0D; Keywords: Mucinous carcinoma, Gall bladder, Adenocarcinoma, Metastatic deposits

Primary adenocarcinoma of the urinary bladder: Report of two cases with a literature review

Urothelial carcinoma is the most discussed form of bladder cancer. However, there are also other histological subtypes, such as adenocarcinoma, which have different presentations, treatment strategies, and prognosis. Primary adenocarcinoma of the urinary bladder can be classified as urachal adenocarcinoma and nonurachal adenocarcinoma. The average age of patients with urachal adenocarcinoma is about one decade younger than those with the nonurachal subtype, and the prognosis of urachal adenocarcinoma is better. Complete surgical resection is the standard treatment, but adjuvant therapy is always needed due to the high relapse rate. Due to the rareness, research about this malignancy is limited. Herein, we report two cases with different primary adenocarcinomas of the urinary bladder and perform a literature review.