Plasmacytoid transitional cell carcinoma of the urinary bladder

A case of rare plasmacytoid transitional cell carcinoma of the urinary bladder in a 60-year old man is described. The presence of end-stage disease did not allow for any efficacious therapy. Immunohistochemistry showed the tumor cells to be reactive for epithelial markers and syndecan-1 (CD138).     

Clinical study of transitional cell carcinoma of the prostate associated with bladder transitional cell carcinoma

BACKGROUND: Transitional cell carcinoma of the prostate in patients with bladder cancer appears to influence the prognosis and affects the decision about therapeutic modality. Therefore, it is important to characterize transitional cell carcinoma associated with bladder cancer. METHODS: From April 1980 to December 1998, 81 male patients underwent total cystoprostatectomies for transitional cell carcinoma of the bladder. The 81 cystoprostatectomy specimens were examined to clarify the characteristics of prostatic involvement by transitional cell carcinoma. The extent, origin, mode of spread and risk factor of prostatic involvement as well as the prognosis were investigated. In 13 of 15 patients with prostatic involvement the prostate was examined by sequential step sections. RESULTS: Prostatic involvement was observed in 15 of 81 patients (18.5%). Prostatic urethral involvement, invasion to prostatic duct/acinus, prostatic stromal invasion and extraprostatic extension and/or seminal vesicle involvement were recognized in 12 (80%), 14 (93.3%), six (40%), and five (33.3%) of the 15 patients, respectively. Twelve of the 15 patients (80%) with prostatic involvement had papillary or non-papillary tumors (i.e. carcinoma in situ) both in the prostatic urethra and prostatic duct. In 10 of these 12 patients (88.3%), there was contiguity between prostatic urethral and ductal tumors. Seven of the 23 patients (30.4%) with carcinoma in situ of the bladder showed prostatic involvement, which increased to 50% in the presence of carcinoma in situ of the trigone or bladder neck. CONCLUSIONS: Eighty per cent of the patients with prostatic involvement showed papillary or non-papillary tumors both in the prostatic urethra and prostatic duct. There was a high level of contiguity between both tumors. Patients with carcinoma in situ of the trigone or bladder neck revealed significantly higher incidence of prostatic involvement.     

Upper urinary tract transitional cell carcinoma in patients with bladder carcinoma and associated vesicoureteral reflux

Of 269 patients with bladder neoplasms treated during a 20-year period 47 had associated vesicoureteral reflux. All 47 patients were followed for 3 years or more, or until death. Upper urinary tract transitional cell cancer developed in 3, each of whom had recurrent bladder cancer. Among the 222 patients who had vesical cancer without reflux transitional cell carcinoma of the ureter developed in only 1, 11 years after transurethral resection for a bladder tumor. The incidences of upper tract transitional cell cancer in patients with and without vesicoureteral reflux were 6.4 and 0.44 per cent, respectively, which support the suggested role of reflux in disseminating or seeding of cancer cells from the bladder into the upper urinary tract. Patients with bladder cancer and associated vesicoureteral reflux have an approximately 15-fold greater risk of upper tract cancer developing compared with those without reflux. We recommend vigilant scrutiny of patients with recurrent bladder cancer and associated vesicoureteral reflux for early detection of upper urinary tract transitional cell carcinoma.     

Cystic renal cell and squamous cell carcinoma of single kidney with concurrent transitional cell carcinoma of ipsilateral ureter and urinary bladder.

We report on a case of the simultaneous occurrence of cystic renal cell and squamous cell carcinoma in a single kidney in a patient with concurrent transitional cell carcinoma of the ipsilateral ureter and urinary bladder. A review of the literature reveals this to be the first such occurrence.     

Giant cell tumor of the bladder associated with transitional cell carcinoma

We report in detail the first giant cell tumor associated with transitional cell carcinoma of the bladder. The giant cell tumor was composed of multinucleated giant and mononuclear stromal cells, and was morphologically indistinguishable from giant cell tumor of the bone. The giant and transitional cell carcinomas showed no evidence of recurrence or metastasis 8 months after transurethral resection. No histogenetic correlation between the cancers was found.     

Metastases from transitional cell carcinoma of urinary bladder

In 107 patients who died of metastatic transitional cell carcinoma, the most common sites for metastases at necropsy were the lymph nodes, liver, lung, bone, and adrenal gland. Metastases first were documented clinically in multiple-organ sites in one third of the patients; solitary metastases were present in only 9 patients at necropsy. The mean duration of survival for patients was thirteen months from the diagnosis of the primary tumor. The metastatic lesion(s) generally were evident clinically within eleven months of the primary diagnosis; death ensued usually within three months. Our finding that the majority of patients presented initially with highgrade tumors suggests that a high-grade lesion, regardless of its clinical stage, warrants early aggressive therapy.     

Nephrotic syndrome associated with transitional cell carcinoma of the bladder

We describe the occurrence of a nephrotic syndrome in association with transitional cell carcinoma of the bladder. The proteinuria disappeared several weeks after removal of the tumor. Light and electron microscopy were compatible with a minimal-change lesion, but immunofluorescence showed linear immunoglobulin deposition. Immunoglobulins eluted from the tumor reacted specifically with the kidney and vice versa. We conclude that antibody formation against a specific component of basement membrane common to both kidney and tumor gave rise to the nephropathy in this case.     

Interleukin-4 gene intron-3 polymorphism is associated with transitional cell carcinoma of the urinary bladder

OBJECTIVE: To evaluate whether polymorphism of the interleukin-4 gene exon 3, and of the interleukin-1beta gene exon 5 and promoter region, are associated with transitional cell carcinoma (TCC) of the urinary bladder, as cytokines are hypothesized to be important in cancer formation. PATIENTS, SUBJECTS AND METHODS: The study included 138 patients with TCC of urinary bladder and 105 healthy controls living in the same area. Each genetic polymorphism was typed using polymerase chain reaction-based restriction analysis. Genotype distribution and allelic frequencies between patients and controls were compared. RESULTS: There were significant differences in genotype and allelic distribution of intron 3 RP1/RP2 polymorphism (P < 0.001), but no significant difference in genotype distribution or allelic frequencies of the interleukin-1beta gene polymorphism between patients with bladder cancer and controls. CONCLUSION: The interleukin-4 gene intron 3 polymorphism is associated with bladder cancer and is a potential genetic marker in screening for the possible causes of bladder cancer.     

Giant cell reparative granuloma of the bladder associated with transitional cell carcinoma

We report a case of benign giant cell tumor of the bladder associated with transitional cell carcinoma. This giant cell granuloma represents a reactive reaction that must be distinguished from the giant cell malignant tumor. The morphological, histochemical and immunohistochemical criteria that can aid in the differential diagnosis are discussed.     

K-Ras mutation in transitional cell carcinoma of urinary bladder

In the present study it was aimed to investigate the frequency of K-RAS mutation in the human bladder transitional cell carcinoma. For thispurpose, tissue specimens obtained from the patients with bladder tumors.Genomic DNAs were isolated and then PCR-SSCP analysis of K-RAS genewere performed. A heterozygous deleted mutation was detected in K-RAS oncogene (exon 2) in agorose gel electrophoresis in one patient andpoint or substitution mutations are detected using single strandconformational polymorphism (SSCP) in other different patients withbladder cancer (4/14). In conclusion, the frequency of K-RAS mutationis not rare and the role of this mutation in oncogenesis and in infiltrationof the urinary bladder wall needs to be confirmed in a larger study.     

Synchronously occurring transitional cell carcinoma of the ureter with adrenocortical carcinoma

A sixty eight-year-old man was admitted to our hospital complaining of macroscopic hematuria. Ultrasonography, X-ray and laboratory examination revealed a right ureter tumor and left non-functioning adrenal tumor. Pathological diagnosis was transitional cell carcinoma of the ureter and left adrenocortical carcinoma. A review of persistent Japanese literature revealed this case to be the 97th case of non-functioning adrenocortical carcinoma and the first case synchronously occurring with transitional cell carcinoma of the ureter. Forty eight cases of synchronously occurring transitional cell carcinoma of the ureter with cancers in other organs, especially renal cell carcinoma and gastric cancer, have been reported. Recently, an increasing number of cases of non-functioning adrenal carcinoma are detected by CT scan, ultrasonography, adrenal radioisotopic scintigraphy and urinary 17-OHCS, 17-KS.     

Penile metastasis arising from transitional cell carcinoma of the urinary bladder

Metastatic spread of transitional cell carcinoma of the bladder to the penis is very rare. We present 1 such case in a 63-year-old man that was treated by total penectomy and adjuvant systemic chemotherapy.     

Cell-mediated tumour immunity in patients with transitional cell carcinoma of the urinary bladder

Some recent data on problems of cell-mediated immune reaction directed against tumour-associated antigens (TAA) of transitional cell carcinomas of the urinary bladder (BTCC) are reviewed. All of the 13 samples of BTCC examined in our laboratory using a lymphocytotoxicity microassay contained the characteristic TAA of urinary bladder carcinomas. TAA were absent in 14 control tissue samples. Forty-seven out of 70 (67%) patients with BTCC developed cytotoxic lymphocytes reacting, with BTCC cells. However, cytotoxic lymphocytes were also found in the blood of 8 out of 165 (4.8%) control lymphocyte donors.     

Enzyme studies in human transitional cell carcinoma of the urinary bladder

The activities of six enzymes of carbohydrate metabolism were estimated in tissue samples from 99 patients with transitional cell carcinoma of the urinary bladder undergoing transurethral resection. The results were analysed according to the stage of the disease and the malignancy grade of the carcinoma. There were statistically significant differences in the activities of three enzymes between various stages and grades. The activities of phosphofructokinase (PFK), alpha-glycerolphosphate dehydrogenase (alpha-GPDH), and phosphohexose isomerase (PHI) showed significant decreases with increased stage and grade. Of the total of 64 patients with superficial disease at presentation, five developed progressive disease during the course of this investigation. The activities of the three enzymes in these patients were compared to the median values for the group of patients with superficial disease. The activity of PFK was observed to be below the median value in all the five patients whereas the activities of alpha-GPDH and PHI showed similar patterns in four of the five patients. These preliminary data indicate that, in association with established clinical parameters, the measurement of the activity of these three enzymes may prove useful in selecting patients with an increased potential for developing progressive disease.     

Brain metastases from transitional cell carcinoma of urinary bladder.

Of 293 patients with transitional cell carcinoma of the bladder seen at our institution between April 1977 and December 1987, 9 patients were found to have brain metastasis. Seven of 9 patients were found to have a solitary brain lesion, and in 4 of these, no other site of metastatic disease was identified. Five patients received palliative whole brain irradiation, 3,000 cGy in 10 fractions, due to the presence of multiple lesions of the central nervous system (CNS) or metastases to other sites. The average survival for this group was seven weeks. One patient with a solitary brain metastasis and no other documented metastatic site was hospitalized at another institution, and was managed expectantly receiving only parenteral steroid therapy and survived four weeks. Three patients with solitary lesions and no evidence of other metastatic sites were treated with a combined surgical and radiotherapeutic approach receiving 4,000-5,000 cGy to the lesion site postoperatively. The average survival of that group was twenty-nine months, with one five-year survivor and 1 patient with no evidence of disease fourteen months after treatment. It appears that survival is longer in those patients with solitary lesions, perhaps due, at least in part, to a more aggressive therapeutic approach.