Clear cell adenocarcinoma of the urinary bladder inducing acute renal failure

Abstract

We report a case of clear cell adenocarcinoma of the urinary bladder. A 59-year-old male was referred to our hospital complaining of oliguria, left lower abdominal pain and loss of appetite. Ultrasonography revealed bilateral hydroureteronephrosis and obstructions at the ureterovesical junction. Magnetic resonance imaging demonstrated an invasive irregular tumor located in the posterior wall of the urinary bladder and urinary infiltration to the left retroperitoneal space. The clinical diagnosis was acute post renal failure due to bilateral ureteral obstructions from an invasive bladder tumor. After we performed bilateral percutaneous nephrostomy, the patient underwent transurethral biopsy of the bladder tumor, which showed clear cell adenocarcinoma extending from the submucosa to the muscular layer, histopathologically. The patient died of metastatic disease 8 months after diagnosis. To our knowledge, the present case is the 23rd to be reported and demonstrates the shortest survival period in the related literature.

Primary clear cell adenocarcinoma of the bladder with recurrence: a case report and literature review

“…In general, it is more malignant than common urothelial carcinoma, but more cases and longer follow-up periods are required to elucidate these points. Lymph nodes and bone seem to be the most common metastatic sites for this disease [6,15]. In the current case, the patient was found to have multiple cervical lymphadenectasis and suspected lymphadenectasis around right iliac vessels and inguinal regions after the initial treatment.…”

“…The usual presenting symptoms included gross hematuria, dysuria, recurrent UTI and suprapubic pain. Patients rarely complained of local tumor effects or pain from local spread of the tumor [6]. Based on available data, the most common locations which tumors originated from were bladder neck and posterior wall, with incidence 31.6% (12/38) and 26.3% (10/38) respectively.…”

“…No effect of radiotherapy was observed because two cases died with disease in 8 months and 1 year, the other two alive with no evidence of disease in 18 months and 2 years [5-7]. Some patients underwent chemotherapy (including cisplatin, doxorubicin or cyclophosphamide) and/or radiotherapy (40-60 Gy total) as the adjunvant treatment, but with uncertain effects [5,6,15]. …”

Clear-Cell Adenocarcinoma of Vesical Origin: A Case Study of Metastatic Disease Treated with Chemotherapy

“…In another case of extravesical spread, in which surgical treatment was not contemplated, the evolution was very poor, and the patient died eight months after diagnosis due to metastatic disease [9]. Only one case of radiotherapy treatment alone has been described, resulting in complete response of the localised disease [10].…”

Clear cell carcinoma of the lower urinary tract in a male patient. Presentation and update on histogenesis and management

“…CCC seems to be a particularly aggressive tumor and radical surgery with adjuvant chemotherapy is considered to be the treatment of choice 12 . In contrast, the accumulated experience confirms that despite high stage at diagnosis, a favorable prognosis is maintained regardless of length of follow up 13 …”