Primary signet-ring cell carcinoma of the urinary bladder: a case report

We report a case of signet-ring cell carcinoma of the urinary bladder. A 48-year-old female was hospitalized because of general fatigue, pollakiuria and residual sensation. Renal ultrasonography disclosed bilateral hydronephrosis. The serum level of cretinine was 3.1 mg/dl, and we diagnosed the patient with post-renal failure. Cystoscopic examinations revealed non-papillary sessile tumors in the trigone. Histopathological findings of the biopsy specimen demonstrated signet-ring cell carcinoma. There was no evidence indicating bladder metastasis from the cancer in other organs. The patient died of cachexia 5 months after the diagnosis. She was autopsied, and the diagnosis of signet-ring cell carcinoma of the urinary bladder with metastases in various organs was confirmed. This disease is extremely rare and has a poor prognosis. We review the previous cases reported in the literature.     

Transitional cell carcinoma of the urinary bladder in adolescence: report of a case

The patient is a 17 year-old girl who was admitted with the chief complaint of asymptomatic gross hematuria. Excretory urography showed a filling defect of the urinary bladder. Abdominal echography showed a papillary tumor of the urinary bladder. Cystoscopy showed a papillary bladder tumor on the posterior area of left ureteral orifice. Transurethral resection of the bladder tumor was performed for diagnosis and treatment. Pathological diagnosis was papillary transitional cell carcinoma (grade 1, pTa). Thirty cases of transitional cell tumor of the urinary bladder in childhood and adolescence have been reported in Japan including this case.     

A case of signet-ring cell carcinoma of the urinary bladder

Signet-ring cell carcinoma of the urinary bladder is a rare disease. A 78-year-old man was admitted to our hospital on March 18, 1988 with the complaints of microhematuria and pollakisuria. Cystoscopic examination revealed non-papillary tumor at the dome of the bladder. partial cystectomy was done under epidural anesthesia. Pathological findings revealed signet-ring cell carcinoma. The gastrointestinal, respiratory and genitourinary tracts were examined but no other tumor lesions could be found. The postoperative course was uneventful, and chemotherapy such as biological response modifier was administered. However, the patient died of heart failure on July 14, 1988. This is the sixtieth case reported in the literature.     

Primary signet-ring cell carcinoma of urinary bladder

The tenth reported case of primary signet-ring cell carcinoma of the urinary bladder is described. This adenocarcinoma of varying degrees of differentiation (predominantly, signet-ring cells and, partially, poorly differentiated cells and mucin-secreting columnar cells which were arranged in glandular pattern) involved almost the entire mucosa, invading the inuscularis of bladder wall in places, ejaculating ducts, and prostatic ducts.     

Primary signet-ring cell carcinoma of urinary bladder

A case of primary signet-ring cell carcinoma of the urinary bladder is described clinically and pathologically. In this rare neoplasm the characteristic cells contain large amounts of cytoplasmic mucin which compresses the nucleus to one side. This tumor demonstrates nicely the ability of bladder epithelium to undergo metaplasia. Most previously described cases have pursued a relentlessly progressive and fatal course despite varied forms of therapy.     

Transitional cell carcinoma of the ureter with inverted proliferation accompanied with papillary bladder tumor: a case report

An 85-year-old female was referred to our hospital with chief complaints of right flank pain and gross hematuria. Ultrasonography demonstrated right hydroureteronephrosis and a thumb head-sized solid mass in the lower third of the right ureter. Cystoscopy revealed papillary tumors near the right ureteral orifice. Under the preoperative diagnosis of right ureteral tumor and bladder tumor, transurethral resection of bladder tumor, right nephroureterectomy and partial cystectomy were performed. The gross specimen of the ureter contained a 5 x 3 x 1 cm, polypoid and smooth-surfaced tumor. The pathological diagnosis of the ureteral tumor was transitional cell carcinoma with inverted proliferation, grade 1 > grade 2. On the other hand, the bladder tumor was papillary transitional cell carcinoma, grade 1. This is a case in which tumor development showed two different types.     

Small cell carcinoma of the urinary bladder: a case report

We report a case of small cell carcinoma of the urinary bladder. The patient was a 58-year-old man complaining of gross hematuria. Clinical examination revealed a non-papillary, broad-based tumor on the right bladder wall with a clinical stage of T3a, N0, M0. Neoadjuvant intraarterial infusion chemotherapy with methotrexate, adriamycin and cisplatin was performed, but it was ineffective. Three weeks later we performed a radical cystectomy. The operative specimen of the tumor revealed small cell carcinoma. It was staged pT3aN0M0R0L2V1. Postoperatively, 1 course of adjuvant chemotherapy using cisplatin and etoposide was performed. The patient is alive without any evidence of tumor recurrence at 6 months after operation.     

Small cell carcinoma of the urinary bladder: a case report

We report a case of primary small cell carcinoma of the urinary bladder. A 74-year-old woman was referred to our hospital because of pollakiuria. Cystoscopy showed a papillary tumor. We operated transurethral resection of the bladder tumor (TUR-Bt). Histopathological finding was transitional cell carcinoma (TCC), grade3, pT1 containing pTis. About six months later, tumor recurred to the bladder. Pathologic diagnosis was TCC in part and most was small cell carcinoma. Pelvic magnetic resonance imaging revealed a huge mass lesion with extravesical extension in the urinary bladder, and computed tomography scan showed external iliac lympho node metastasis. The rapid rise of a tumor maker NSE and pro-GRP were remarkable. It was diagnosed as a rapid advance of small cell carcinoma. We performed pelvic radiotherapy, and chemotherapy using carboplatin (CBDCA) and etoposide (VP-16). However 14 months after it had left hospital, computed tomography showed paraaortic lympho node metastasis. The patient died due to rapidly progressive disease.     

Alpha-fetoprotein-producing transitional cell carcinoma of the urinary bladder: a case report

We report a 76-year-old man with alpha-fetoprotein (AFP)-producing transitional cell carcinoma of the bladder. Although the serum level of AFP was 1,428 ng/ml, and he was anti-hepatitis C virus (anti-HCV) antibody-positive, liver tumors were not detected by either a computed tomography (CT) scan or a hepatic angiography. However, removal of a bladder tumor by transurethral resection and subsequent pathological examination revealed a grade III transitional cell carcinoma (TCC). Furthermore, immunohistochemical detection of AFP was diffuse-positive. After the tumor partially responded to concomitant chemoradiotherapy, the serum AFP levels decreased to 966 ng/ml. However, the tumor eventually progressed with multiple lung metastases, and serum AFP levels increased to 3,906 ng/ml. In conclusion, AFP-producing TCC of urinary bladder is rare, and the nature and pathophysiology remains unclear and warrants further investigation.     

Signet ring cell carcinoma of the urinary bladder: a case report

A 69-year-old man was admitted complaining of macroscopic hematuria. Cystoscopic examination revealed a non-papillary tumor at the anterior wall of the urinary bladder. A pelvic computed tomographic (CT) scan showed marked thickening of the anterior bladder wall. Radical cystectomy and bilateral ureterocutaneostomy were performed. Histopathological examination revealed signet ring cell carcinoma of the bladder, stage pT3bN1M0. This tumor is rare, and has a poor prognosis. Our patient has been well without any evidence of disease 6 months after surgery. To the best of our knowledge, there are 44 reported cases, and our case is the 45th in Japan.     

Small cell carcinoma of the urinary bladder: a case report]

We report a case of small cell carcinoma of the urinary bladder. A 60-year-old man with microscopic hematuria was referred to our hospital. Cystoscopy revealed a sessile tumor on the left lateral wall of the urinary bladder. The patient underwent transurethral resection of the bladder tumor (TUR-Bt). Because of muscle invasion (pT2), total cystectomy was recommended, but was not performed because the patient would not give consent for the operation. Six months after TUR-Bt, invasive bladder tumor recurred and total cystectomy was performed. Pathological examination of the operative specimen revealed small cell carcinoma. Adjuvant combined therapy of irradiation and chemotherapy (nedaplatin and etoposide) was ineffective. Metastases to retroperitoneal lymph nodes, lung and liver were detected soon after the adjuvant therapy. The patient died 15 months after his first visit to our hospital.     

Transitional cell carcinoma of the ureter with an inverted growth pattern which was accompanied with bladder tumor: a case report

The patient was a 75-year-old man who complained of macrohematuria which had set in from April 12, 1988. Under the clinical diagnosis of bladder tumor, total cystectomy with ureterosigmoidostomy was performed on June 25. During his surgery, we discovered a polypoid lesion of the right ureter close to the common iliac artery. The tumor was peanut-sized and had a stalk suggesting benign nature, so we resected it. Postoperative pathological examination revealed the tumor was transitional cell carcinoma (grade 2) with an inverted growth pattern. Though we could find no signs of tumor recurrence, the presence of tumor's residuum could not be ruled out. We performed nephroureterectomy of the right side on December 19. Follow-up on July 1, 1989 this patient revealed no tumor recurrence.     

Transitional cell carcinoma of the bladder in a young patient: a case report]

A 14-year-old male patient was admitted with the chief complaint of macroscopic hematuria. Abdominal ultrasonography demonstrated a tumor of the anterior wall of the bladder. Further, cystoscopic examination confirmed a papillary tumor. Transurethral resection of the bladder tumor was performed. Histopathology of the excised tumor showed transitional cell carcinoma (G1, pTa). Recurrence has not been observed for 9 months postoperatively.     

Small cell neuroendocrine carcinoma of the urinary bladder: a case report]

A 60-year-old male was referred to our hospital with a complaint of asymptomatic gross hematuria. Cystoscopic examination revealed a non-papillary broad-based tumor on the posterior wall of the urinary bladder. Computed tomography revealed no evidence of metastases. Transurethral resection of bladder tumor (TUR-BT) was performed and muscle invasion was detected by histological examination of the specimen. Total cystectomy and ileal conduit formation were performed at the preoperative diagnosis of T2-3N0M0. Hematoxylin-eosin staining of the specimen revealed small cancer cells with hyperchromatic nucleus and scanty cytoplasm growing in the muscle layer of the urinary bladder and in the left obturator lymph nodes. Immunohistochemistry for neurospecific enolase showed diffuse staining in the cytoplasm of cancer cells, and ultrastructural study showed dense core granules. From these findings, the patient was diagnosed with small cell neuroendocrine carcinoma of the urinary bladder at the stage of pT3bpN1M0. Three courses of adjuvant chemotherapies with cis-platinum (CDDP) and etoposide were administered. The patient is still alive with no evidence of any recurrence at 22 months after the operation. This case suggests that treatment with combined total cystectomy and adjuvant CDDP and etoposide chemotherapies is effective against neuroendocrine carcinoma of the urinary bladder with regional lymph node metastases.     

Primary signet ring cell carcinoma of the urinary bladder: a case report

Gross hematuria and urinary frequency caused a 71-year-old man to visit our hospital. A non-papillary tumor was identified on the posterior wall of the urinary bladder and the pathological diagnosis was signet ring cell carcinoma. Upper gastrointestinal endoscopy, computed tomographic scanning, barium enema revealed no involvement of other organs. Radical cystectomy and creation of an ileal conduit were performed. The histopathological stage was pT4N1M0. Apart from subacute ileus, the postoperative course was uneventful. Signet ring cell carcinoma of the bladder is a rare entity and we have identified 41 cases in the Japanese literature. This tumor usually has a poor prognosis. Our patient is currently free from disease at 5 months after the surgery.     

Primary signet-ring cell carcinoma of the urinary bladder inducing renal failure

A case of primary signet-ring cell carcinoma of the urinary bladder that was found to have induced renal failure is the second such case reported in the world. Primary signet-ring cell carcinoma of the urinary bladder is a rare histologic variant of adenocarcinoma. The patient died of distant metastasis 8 months after undergoing total cystectomy. The neoplasm had a high stage at diagnosis, so the prognosis was very poor. To improve the prognosis, earlier diagnosis and establishing a regimen of chemotherapy is necessary.     

原发性膀胱印戒细胞癌的诊断和治疗：附2例报告

目的提高对原发性膀胱印戒细胞癌的认识和诊治水平。方法回顾分析我院收治的2例原发性膀胱印戒细胞癌,结合文献就其临床表现、诊断及治疗进行讨论。第1例患者,男,57岁,以全程肉眼血尿和继发的贫血就诊,CT检查示膀胱顶部占位性病变,界限清楚,有斑点状钙化。第2例患者,男,66岁,以黏液尿就诊,无其他临床表现,CT示膀胱右侧壁占位性病变。均于术前膀胱镜活检明确诊断。第1例因患者拒绝膀胱全切除术行膀胱部分切除术加脐尿管和相邻腹膜的切除术,第2例因陈旧性心肌梗塞行膀胱部分切除术。结果第1例患者术后血尿消失,贫血纠正。7个月后发现肺部转移,术后8个月死亡。第2例术后黏液尿和膀胱刺激症状消失。随访37个月,患者恢复良好,无复发和转移。结论原发性膀胱印戒细胞癌临床罕见,预后较差,诊断主要依赖病理学检查,全膀胱切除术是其首选治疗方法。     

Leiomyosarcoma and transitional cell carcinoma in the urinary bladder: a case report

A 74-year-old man was admitted for asymptomatic macroscopic hematuria. He had undergone transurethral resection of bladder tumor (TURBT) due to transitional cell carcinoma 30 years ago. Pelvic CT showed two invasive bladder tumors. A 5 cm tumor was on the dome and a 1 cm tumor was on the left lateral wall. TURBT was performed. Pathological examination revealed that they were leiomyosarcoma and transitional cell carcinoma. Radical cystectomy plus bilateral cutaneousureterostomy was performed. He died of lung metastases and local recurrence after 6 months.