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Garg H, Nayak B, Nakra T, Singh P, Kaushal S. Clear cell carcinoma of Mullerian origin in the urinary bladder: A rare entity. JOURNAL OF CLINICAL UROLOGY 2021. [DOI: 10.1177/2051415820987668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Mullerian neoplasms of the urinary system are rare but complex tumor-like lesions. The identification of the Mullerian neoplasm is crucial for patient management owing to its etiology, natural history, and prognosis. We present a case of a 42-year-old female with a history of three lower segment cesarean sections presenting with complaints of dysmenorrhea and suprapubic pain with no history of hematuria or any urinary symptoms. Magnetic resonance imaging revealed a 2 cm×2 cm exophytic lesion suspicious of being either a bladder lesion or an endometrial lesion infiltrating the urinary bladder. Cystoscopy and transurethral biopsy of this suspicious bladder tumor revealed a malignant tumor with papillary and tubulocystic architecture. Based on the overall histomorphological and immunohistochemical features, a diagnosis of clear cell carcinoma of Mullerian origin was made, and the patient underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy and partial cystectomy. The patient was kept on regular surveillance and showed no signs of recurrence at the one-year follow-up. Clear cell carcinoma of the bladder of Mullerian origin is a rare entity and is established on histopathology. Prompt diagnosis and a multidisciplinary approach are indispensable for management. Level of evidence: Level 4.
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Affiliation(s)
- Harshit Garg
- Department of Urology, All India Institute of Medical Sciences, India
| | - Brusabhanu Nayak
- Department of Urology, All India Institute of Medical Sciences, India
| | - Tripti Nakra
- Department of Pathology, All India Institute of Medical Sciences, India
| | - Prabhjot Singh
- Department of Urology, All India Institute of Medical Sciences, India
| | - Seema Kaushal
- Department of Pathology, All India Institute of Medical Sciences, India
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Zhou Z, Kinslow CJ, Wang P, Huang B, Cheng SK, Deutsch I, Gentry MS, Sun RC. Clear Cell Adenocarcinoma of the Urinary Bladder Is a Glycogen-Rich Tumor with Poorer Prognosis. J Clin Med 2020; 9:E138. [PMID: 31947882 PMCID: PMC7019566 DOI: 10.3390/jcm9010138] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 12/29/2019] [Accepted: 12/30/2019] [Indexed: 11/16/2022] Open
Abstract
Clear cell adenocarcinoma (CCA) is a rare variant of urinary bladder carcinoma with a glycogen-rich phenotype and unknown prognosis. Using the National Cancer Institute's surveillance, epidemiology, and end results (SEER) program database, we documented recent trends in incidence, mortality, demographical characteristics, and survival on this rare subtype of urinary bladder cancer. The overall age-adjusted incidence and mortality of CCA was 0.087 (95% confidence interval (CI): 0.069-0.107) and 0.064 (95% CI: 0.049-0.081) respectively per million population. In comparison to non-CCAs, CCAs were more commonly associated with younger age (<60 years old, p = 0.005), female (p < 0.001), black ethnicity (p = 0.001), grade III (p < 0.001), and higher AJCC 6th staging (p < 0.001). In addition, CCA patients more frequently received complete cystectomy (p < 0.001) and beam radiation (p < 0.001) than non-CCA patients. Our study showed a poorer prognosis of CCAs compared to all other carcinomas of the urinary bladder (p < 0.001), accounted for by higher tumor staging of CCA cases. This study adds to the growing evidence that glycogen-rich cancers may have unique characteristics affecting tumor aggressiveness and patient prognosis. Additional mechanistic studies are needed to assess whether it's the excess glycogen that contributes to the higher stage at diagnosis.
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Affiliation(s)
- Zhengqiu Zhou
- Department of Molecular and Cellular Biochemistry, University of Kentucky College of Medicine, Lexington, KY 40536, USA; (Z.Z.); (M.S.G.)
| | - Connor J. Kinslow
- Department of Radiation Oncology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY 10032, USA; (C.J.K.); (S.K.C.); (I.D.)
| | - Peng Wang
- Division of Medical Oncology, Department of Internal Medicine, College of Medicine, University of Kentucky, Lexington, KY 40536, USA;
| | - Bin Huang
- Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY 40536, USA;
| | - Simon K. Cheng
- Department of Radiation Oncology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY 10032, USA; (C.J.K.); (S.K.C.); (I.D.)
- Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Israel Deutsch
- Department of Radiation Oncology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY 10032, USA; (C.J.K.); (S.K.C.); (I.D.)
- Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Matthew S. Gentry
- Department of Molecular and Cellular Biochemistry, University of Kentucky College of Medicine, Lexington, KY 40536, USA; (Z.Z.); (M.S.G.)
- Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA
| | - Ramon C. Sun
- Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA
- Department of Neuroscience, University of Kentucky College of Medicine, Lexington, KY 40536, USA
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Kulkarni MM, Sinai Khandeparkar SG, Joshi AR, Bhayekar P. Rare Case of Primary Clear Cell Carcinoma of the Urinary Bladder. Niger Med J 2019; 60:40-42. [PMID: 31413434 PMCID: PMC6677001 DOI: 10.4103/nmj.nmj_8_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Cancers of the urinary bladder account for about 3.2% of all cancers worldwide. Clear cell adenocarcinomas (CCAs) of urinary bladder are rare. CCA must be differentiated from benign condition such as nephrogenic adenoma (NA) as well as malignant conditions such as urothelial carcinoma with clear cells, metastasis from ovary and kidney, and urinary bladder myomelanocytic tumor. The diagnosis is based on characteristic histopathological and immunohistochemical features. We present a rare case of CCA of urinary bladder with aggressive clinical behavior in a 72-year-old female.
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Affiliation(s)
- Maithili Mandar Kulkarni
- Department of Pathology, Shrimati Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India
| | | | - Avinash R Joshi
- Department of Pathology, Shrimati Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India
| | - Pallavi Bhayekar
- Department of Pathology, Shrimati Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India
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Jayawardhana T, Alsayed H, Goel A, Madaan S. Non-muscle-invasive clear cell carcinoma of the urinary bladder: Is cystectomy necessary? BMJ Case Rep 2019; 12:e226928. [PMID: 30850563 PMCID: PMC6424185 DOI: 10.1136/bcr-2018-226928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2019] [Indexed: 11/03/2022] Open
Abstract
We report the clinical presentation, histological findings and management of a 49-year-old female patient with non-muscle-invasive clear cell carcinoma of the urinary bladder. In the literature, there are only seven such case reports. We feel that transurethral resection of the bladder tumour followed by close cystoscopy surveillance is a suitable management for non-muscle-invasive clear cell carcinoma of the urinary bladder.
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Affiliation(s)
| | - Hossam Alsayed
- Department of Urology & Nephrology, Darent Valley Hospital, Dartford, UK
| | - Amit Goel
- Department of Histopathology, Maidstone Hospital, Maidstone, UK
| | - Sanjeev Madaan
- Department of Urology & Nephrology, Darent Valley Hospital, Dartford, UK
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Moradi M, Shojaei S, Kaseb K, Rezaee H. Primary clear cell carcinoma of urinary bladder: A case report. Urol Case Rep 2017; 16:41-43. [PMID: 29085783 PMCID: PMC5651499 DOI: 10.1016/j.eucr.2017.10.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 09/22/2017] [Accepted: 10/05/2017] [Indexed: 12/04/2022] Open
Affiliation(s)
- Mahmoudreza Moradi
- Chairman of Urology Department in Imam Reza General Hospital and Chairman of Regenerative Medicine Research Center (RMRC), Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Kaveh Kaseb
- Urology Resident in Kermanshah University of Medical Sciences, Iran
| | - Haress Rezaee
- Urology Resident in Kermanshah University of Medical Sciences, Iran
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