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。     

原发性膀胱印戒细胞癌1例报告并文献复习

目的：探讨原发性膀胱印戒细胞癌的临床特征。方法：报告1例原发性膀胱印戒细胞癌患者的临床资料。患者因间歇性肉眼血尿就诊,术前检查未找到任何膀胱外病灶,行膀胱全切除术＋输尿管造瘘术。结果：术后病检报告为膀胱印戒细胞癌。患者术后转肿瘤科化疗,目前正在随访中。结论：原发性膀胱SRCC非常罕见,进展快、恶性程度高,局部浸润性生长,有早期扩散转移倾向,预后差。其确诊主要依靠病理组织学检查。     

Apparently bladder origin signet ring cell carcinoma: a case report

A 72-year-old woman with signet-ring cell carcinoma of the urinary bladder treated with total cystectomy is described. The bladder yielded linitis plastica pattern of infiltration similar to that seen in the gastric cancer, i.e., cancer tissue extended almost whole bladder deeply to the serosa, whilst the mucosal surface was only minimally invaded. She received no adjuvant therapy and she is alive without recurrence 8 months after the operation. We review the reported cases and shortly discuss the prognosis and treatment of primary signet-ring cell carcinoma of the urinary bladder.     

Superficial and pedunculated signet ring cell carcinoma of the urinary bladder: a case report]

A case of primary signet ring cell carcinoma of the urinary bladder is described. A 63-year-old man presenting with difficulty of urination and miction pain had a pedunculated soybean-size tumor on the left lateral wall of the bladder. Specimens of the tumor were obtained by transurethral resection and the pathological diagnosis was signet ring cell carcinoma. There was no evidence of bladder metastasis from other organs. The patient then had intraoperative radiotherapy and he is alive without recurrence 20 months after the operation. We briefly discuss 73 cases of signet ring cell carcinoma of the urinary bladder collected from the English and Japanese literature. The tumor in this patient was the smallest of all cases reported previously.     

Transitional cell carcinoma of the urinary bladder accompanied by signet-ring cell carcinoma: a case report

A 58-year-old man visited our clinic with complaints of gross hematuria and pollakisuria. Cystoscopic examination revealed multiple non-papillary broad based tumors and reddish unstable mucosa in the bladder. The pathological specimen of the transurethral biopsy of the tumors showed signet-ring cell carcinoma predominantly and adenocarcinoma transforming into signet-ring cell carcinoma partially. A total cystectomy with ileal conduit urinary diversion was performed. The histopathological finding of the radical cystectomy specimen was grade 3 transitional cell carcinoma accompanied by adenocarcinoma. These findings suggest that the adenomatous metaplasia of transitional cell carcinoma in the bladder could differentiate into signet-ring cell carcinoma.     

Signet-ring cell adenocarcinoma involving the bladder and the rectum. Apropos of two cases]

Two cases of primary signet-ring cell carcinoma involving the urinary bladder, with invasion of the rectum, are presented. Pelvic exenterations were performed, followed by a rapidly fatal outcome (6 and 7.5 months). These cases of signet-ring cell carcinoma of the bladder were reviewed with 33 previously reported cases in the literature. The clinical characteristics, histologic findings, pathogenesis, and effectiveness of aggressive treatment of this rare bladder malignancy are discussed.     

A case of primary transitional cell carcinoma of the prostate]

We report a rare case of primary transitional cell carcinoma of the prostate. A 66-year-old man was referred to our hospital with the chief complaints of pollakisuria and residual urine sensation on January 21, 1998. Under a preoperative diagnosis of benign prostatic hyperplasia, transurethral resection of the prostate was performed. Histopathological examination revealed grade 3 transitional cell carcinoma. Then the transrectal needle biopsy of the prostate and random biopsy of the urinary bladder were performed. Since no metastatic tumors or tumor cells were detected in either the prostate or urinary bladder or any other organs, this patient was diagnosed with primary transitional cell carcinoma of the prostate. Three courses of adjuvant chemotherapy (M-VAC) were performed, and tumor recurrence was not recognized 9 months after the operation. This is the 35th case of primary transitional cell carcinoma of the prostate in the Japanese literature.     

Signet-ring cell carcinoma involving the urinary bladder. Report of a case and review of 21 cases

A case of signet-ring cell carcinoma involving the urinary bladder, which is a rare variant of adenocarcinoma, is presented. 21 cases have so far been reported in the occidental and Japanese journals. In 13 patients (62%) the carcinomas were of urachal origin and 8 (38%) of bladder origin. The prognosis of signet-ring cell carcinoma originating in bladder is poorer compared to that in urachus; 2-year survival of 40% for the bladder cancer group and 70% for the urachus. A radical cystectomy with excision of adjacent tissues, which might improve the prognosis in this fatal malignancy, should be considered.     

Primary signet ring cell carcinoma of bladder

Patients presenting with rare primary signet-ring cell carcinoma of the bladder are often found to be in renal failure and to have distressing symptoms of bladder instability. Their clinical course most often is rapidly fatal, and radical cystectomy with urinary diversion offers the only hope of increasing longevity. We herein review the literature of this rare variant of bladder adenocarcinoma and present a case in which a unique form of urinary diversion reversed the uremic state and increased this patient's longevity.     

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.     

A case of secondary malignant lymphoma of the urinary bladder

A case of secondary malignant lymphoma of the urinary bladder is presented. Clinical diagnosis was metastatic small cell carcinoma in urinary bladder. Pathological diagnosis after autopsy, however, revealed vesical involvement of malignant lymphoma. The primary focus was considered to be the lung, the biopsy specimen of which was initially diagnosed as small cell carcinoma, because clinical manifestation first occurred in the lung and the metastasis to subcutaneous tissue, bladder and other abdominal organs was found subsequently. In a study of secondary involvement of genitourinary organs as seen in the present case, we reviewed 303 patients who had died of malignant lymphoma at our institute between 1960 and 1985.     

Signet-ring cell carcinoma of the urinary bladder associated with transitional cell carcinoma of the right ureter

We report on a case of a 72-year-old male with vesical signet-ring cell carcinoma containing a transitional cell carcinoma (TCC) component. It was associated with pure TCC of the right ureter. No other microscopic changes were found in the bladder. The pathogenesis of this signet-ring cell carcinoma is described.     

膀胱腺癌的诊断和治疗(附29例报告)

目的提高膀胱腺癌的诊断与治疗水平。方法29例中原发性膀胱腺癌18例，其中行全膀胱切除、尿流改道11例，膀胱部分切除7例；脐尿管腺癌9例，6例行扩大膀胱部分切除术，3例行全膀胱切除、尿流改道；印戒细胞癌2例，行全膀胱切除、尿流改道术。结果4例患者失访，25例患者随访时间为5个月一10年。生存1年者17例（64％），生存2年15例（60％），生存5年5例（20％），生存时间超过5年者均为早期患者。结论早期诊断、鉴别原发性膀胱腺癌与脐尿管腺癌、选择合适的手术方式是膀胱腺癌治疗的关键。     

Signet-ring cell neoplasm. Unusual histologic variety as primary bladder tumor

We report a case of primary signet-ring cell adenocarcinoma of the urinary bladder. It is a extremely rare tumor. Gross hematuria is the commonest clinical presentation as well as this case. Our patient presented with advanced tumour invasion into perivesical fat at dome. The treatment was partial cystectomy together with quimiotherapy. Medical literature are reviewed with special remark on histopathology and its bladder origin.     

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.     

Metastatic renal cell carcinoma to the bladder 12 years after radical nephrectomy

We report, herein, a case of metastatic renal cell carcinoma of the urinary bladder. A 76-year-old man presented to our hospital. He had undergone right radical nephrectomy at 64 years of age. Cystoscopy revealed a solitary, spherical tumor 1.5 cm in size protruding into the urinary bladder. Transurethral resection was performed and the pathological diagnosis of the lesion was clear cell carcinoma. The patient is alive 12 months after recurrence to the bladder, under the administration of interleukin-2.     

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.     

胃低分化腺癌合并印戒细胞癌睾丸转移1例报告并文献复习

目的:探讨我院1例罕见胃印戒细胞癌睾丸转移的临床病理特点,免疫组织化学在睾丸转移瘤与原发肿瘤鉴别诊断中的应用。方法:回顾分析了我院收治1例睾丸肿瘤患者,1年前曾行胃贲门癌根治性全胃切除术,术后病理报告提示低分化印戒细胞癌,术后未予以放化疗,此次外院睾丸穿刺活检病理报告为低分化腺癌浸润或转移,考虑患者的病情及预后,行患侧根治性睾丸切除术。结果:术中见睾丸略增大,约4cm×3cm×2cm,质地硬,颜色呈淡红色,附睾大小、质地无异常。术后病理证实胃低分化腺癌合并印戒细胞癌转移。随访半年,临床症状好转。结论:胃印戒细胞癌睾丸转移非常罕见,特定的免疫组织化学指标可以有助于诊断。     

Primary large cell neuroendocrine carcinoma of the urinary bladder

Large cell neuroendocrine carcinoma (LCNEC) of the urinary bladder is rare. It is a type of neuroendocrine carcinoma morphologically distinct from small cell carcinoma. We report here a case of primary LCNEC of the urinary bladder. We observed a very large invasive tumor, which was not able to be detected three months previously by cystoscopy or computed tomography. The tumor cells morphologically and immunohistochemically resembled that of pulmonary LCNEC. With prompt cystoprostatectomy and chemotherapy, the patient is free of disease 16 months after diagnosis. Although LCNEC is usually very aggressive, it may be controlled by early diagnosis and treatment.