Unusual Faces of Bladder Cancer

Manini, Claudia; López, José I.

doi:10.3390/cancers12123706

Cited by 6 publications

(6 citation statements)

References 81 publications

(96 reference statements)

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“…An immunohistochemical study is a major tool in establishing a diagnosis. Molecular analysis can be useful where applicable [10]. In spindle cell lesions of the bladder, especially those with myxoid stromal features, sarcomatoid urothelial carcinoma, and leiomyosarcoma top the list of differential diagnoses followed by the inflammatory myofibroblastic tumor.…”

Section: Discussionmentioning

confidence: 99%

Sarcomatoid Urothelial Carcinoma With Myxoid Stroma: A Case Report and Diagnostic Approach

Taseer¹,

Ahmed²

2021

Cureus

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Bladder cancer is the seventh most common cancer in the world. Urothelial carcinoma is the most common type of bladder cancer. Other subtypes like squamous cell carcinoma and adenocarcinoma are less common. Urothelial carcinoma has a propensity for divergent differentiation. Sarcomatoid carcinoma is one of the variants of urothelial carcinoma. It is an aggressive tumor that presents at an advanced stage and has a poorer prognosis than conventional urothelial carcinoma. Therefore, identifying this variant histology is important clinically. The sarcomatoid component in sarcomatoid carcinoma can be spindle cell (not otherwise specified), myxoid, pseudoangiosarcomatous, and undifferentiated sarcoma like. Myxoid stroma in sarcomatoid urothelial carcinoma has been described but reported very rarely. We present a case of sarcomatoid urothelial carcinoma with myxoid stroma along with a review of the diagnostic approach to myxoid spindle cell lesions of the urinary bladder.

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Section: Discussionmentioning

confidence: 99%

Sarcomatoid Urothelial Carcinoma With Myxoid Stroma: A Case Report and Diagnostic Approach

Taseer¹,

Ahmed²

2021

Cureus

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“…Pseudo-malignant features like muscle pseudo-invasion, nuclear atypia, and occasional GATA-3 positivity may occur [17]. Special attention should be paid to distinguish urothelial carcinomas mimicking nephrogenic adenomas, especially when NA present a pseudo-infiltrative growth pattern [1,17]. The combined expression of PAX-8 and absence of p63 and GATA-3 should solve difficult cases [16].…”

Section: Nephrogenic Adenoma (Na)mentioning

confidence: 99%

“…Although they are classical entities well-known by pathologists, eventually they may pose diagnostic problems when the submitted material is scarce, superficial, or damaged by the resection procedures. For example, a florid VB must be distinguished from the nested variant of urothelial carcinoma [1]. This differential diagnosis is of crucial importance for the patient since nested urothelial carcinoma is an aggressive subtype of cancer.…”

Section: Florid Von Brunn Nest Proliferation (Vb) Cystitis Cystica (mentioning

confidence: 99%

“…In consequence, the dilemma may even be irresolvable in selected cases, and a new biopsy should be requested before making an overdiagnosis. In the same sense, CC must be distinguished from the microcystic variant of urothelial carcinoma [1]. Glandular mucinous metaplasia may occur in the epithelium of von Brunn nests.…”

Section: Florid Von Brunn Nest Proliferation (Vb) Cystitis Cystica (mentioning

confidence: 99%

“…Some of them are commonly seen, but others are very uncommon and remain a challenge for the urologist when performing cystoscopies or at the time to make decisions when evaluating radiological images. Some of them remain a challenge for the pathologist who must decide if the submitted material includes any lesion representing one of the many faces of bladder cancer [1], other non-urothelial malignant tumors, or simply a non-neoplastic lesion.…”

Section: Introductionmentioning

confidence: 99%

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Mimickers of Urothelial Carcinoma and the Approach to Differential Diagnosis

Manini

Angulo

López

2021

Clinics and Practice

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A broad spectrum of lesions, including hyperplastic, metaplastic, inflammatory, infectious, and reactive, may mimic cancer all along the urinary tract. This narrative collects most of them from a clinical and pathologic perspective, offering urologists and general pathologists their most salient definitory features. Together with classical, well-known, entities such as urothelial papillomas (conventional (UP) and inverted (IUP)), nephrogenic adenoma (NA), polypoid cystitis (PC), fibroepithelial polyp (FP), prostatic-type polyp (PP), verumontanum cyst (VC), xanthogranulomatous inflammation (XI), reactive changes secondary to BCG instillations (BCGitis), schistosomiasis (SC), keratinizing desquamative squamous metaplasia (KSM), post-radiation changes (PRC), vaginal-type metaplasia (VM), endocervicosis (EC)/endometriosis (EM) (müllerianosis), malakoplakia (MK), florid von Brunn nest proliferation (VB), cystitis/ureteritis cystica (CC), and glandularis (CG), among others, still other cellular proliferations with concerning histological features and poorly understood etiopathogenesis like IgG4-related disease (IGG4), PEComa (PEC), and pseudosarcomatous myofibroblastic proliferations (post-operative spindle cell nodule (POS), inflammatory myofibroblastic tumor (IMT)), are reviewed. Some of these diagnoses are problematic for urologists, other for pathologists, and still others for both. Interestingly, the right identification of their definitory features will allow their correct diagnoses, thus, avoiding overtreatment. The literature selected for this review also focuses on the immunohistochemical and/or molecular data useful to delineate prognosis.

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Outcomes of poorly differentiated and plasmacytoid variant bladder urothelial carcinoma

et al. 2021

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Objectives The aim of this study is to assess the course and management of poorly differentiated bladder urothelial carcinoma (UC), including plasmacytoid UC (PUC), in our local area. Although bladder cancer is relatively common, PUC is a rare and aggressive subtype with a poor prognosis that is still poorly understood. Materials and Methods A retrospective assessment of all poorly differentiated high‐grade UC over the last 15 years (2005–2020) in the Hunter New England area was completed. In total, 37 patients were included, and PUC variant was compared with the remaining poorly differentiated UC. Results Of the included cases, eight were PUC, nine squamous variant, two neuroendocrine, and one sarcomatoid. Overall, 23 cases proceeded to cystectomy, 15 had chemotherapy (six neoadjuvant), and 11 had radiation therapy. In the PUC subgroup, three had metastatic disease at diagnosis (37.5%). Of the three PUC patients who underwent cystectomy, all were upstaged. Two PUC cases had adjuvant chemotherapy, and one case had radiation. Within the follow‐up period, the PUC group had a cause‐specific mortality of 50% with a mean survival in these patients of 202 days, compared with 37.9% cause‐specific mortality with survival of 671.55 days (p = 0.23) in all other undifferentiated UC cases; 5‐year cause‐specific mortality with Kaplan–Meier analysis was estimated at 26% compared with 59%, respectively (p = 0.058). Conclusion Poorly differentiated UC is demonstrated to have a poor prognosis with a high mortality rate, particularly when PUC is present. Given the rarity of these variants, further studies are necessary to explore the impact of current treatment options.

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Unusual Faces of Bladder Cancer

Cited by 6 publications

References 81 publications

Sarcomatoid Urothelial Carcinoma With Myxoid Stroma: A Case Report and Diagnostic Approach

Sarcomatoid Urothelial Carcinoma With Myxoid Stroma: A Case Report and Diagnostic Approach

Mimickers of Urothelial Carcinoma and the Approach to Differential Diagnosis

Outcomes of poorly differentiated and plasmacytoid variant bladder urothelial carcinoma

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