https://www.austinpublishinggroup.com/austin-pathology/
Bladdercancer is the second most common tumor in genitourinary tract. Adenocarcinoma
represent less than 2% of all bladder cancers, mucinous variant is even more
rare. They are characterized by a very aggressive behaviour and are not very
sensitive to radio and chemotherapy. They exhibit histological features similar
to those from other sites and adenocarcinoma of urachus, making diagnosis
difficult, hence the primary role of immunohistochemistry in determining
primitive site. Because of its rarity and these difficulties, diagnosis is
always delayed. We report the case of an 80-year-old woman with no pathological
history who consulted for total hematuria. The physical examination revealed a
slight hypogastric sensibility.
Ultrasoundshowed a thickening of the bladder wall with a heterogeneous content from which
the indication of a computerized tomography scan that showed presence of a
bladder tumor process without repercussion on the upper urinary tract. A
transurethral resection of the tumor is performed. Pathological study suggested
the initial diagnosis of a mucinous adenocarcinoma infiltrating bladder muscle.
An immunohistochemical study was performed, having objectified the positivity
of tumor cells to cytokeratin 20 but cytokeratin 7 was negative. Cytoplasmic
staining of the tumor cells with loss of nuclear expression of beta Cathenin
confirmed the primitive character. Patient was readmitted after 6 months for
radical treatment. She had a pelvic anterior flap with an lymph node iliac dissection
and a urinary diversion with cutaneous ureterostomy.
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