Microcystic urothelial carcinoma of the urinary bladder metastatic to the penis.

Izmir Ataturk Training and Research Hospital, Department of Pathology, Izmir, Alsancak, 35220, Turkey.
Pathology & Oncology Research (Impact Factor: 1.81). 02/2007; 13(2):170-3. DOI: 10.1007/BF02893496
Source: PubMed

ABSTRACT Metastatic spread of primary bladder cancer to the penis is an extremely rare event. Microcystic urothelial carcinoma is a very rare variant of urothelial carcinoma. Due to its rareness and insufficient clinical follow-up data, the prognosis of microcystic urothelial carcinoma is still not clear. Here in we report a case of a penile metastasis from microcystic urothelial carcinoma of urinary bladder, in a 56-year-old man who died 6 months after radical cystoprostatectomy and total penectomy. To the best of our knowledge this is the first case report of microcystic variant of urothelial carcinoma which has metastasized to the penis.

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    ABSTRACT: To report on the clinicopathologic features of 20 cases of microcystic urothelial bladder carcinoma. The microcystic component varied from 50-100% of the specimen. The cysts were round-oval and of varying sizes; the periphery of large cysts was frequently punctuated by many smaller cysts. The cysts were lined by urothelial, low columnar cells or by a single layer of flattened epithelium of low-intermediate nuclear grade. Focal high-grade conventional urothelial carcinoma was present in 8 cases. Immunohistochemistry demonstrated variable positivity for cytokeratins 7 and 20, MUC1, MUC5AC, p63, and GATA3. Ki67, p53 and p27(kip1) expressions ranged from 20-60%, 10-40% or 10-30% of cells, respectively. On follow-up, 11 of patients died of disease from 11-56 months, 3 patients were alive with disease at 26-37 months. Univariate survival analysis showed no differences for microcystic carcinoma vs. conventional urothelial carcinoma (p=.548). Microcystic urothelial carcinoma may pose diagnostic difficulties, especially in limited biopsy samples, where it may be mistaken for cystitis glandularis or adenocarcinoma of the bladder. Histologic features, clinical history and appropriate immunohistochemical studies should help distinguish it from its mimickers. Aggressiveness seems to be related to higher stage at diagnosis. This article is protected by copyright. All rights reserved.
    Histopathology 12/2013; DOI:10.1111/his.12345 · 3.30 Impact Factor
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    ABSTRACT: Data on immunohistochemical expression of novel and traditional urothelial markers in the wide range of urothelial carcinoma variants has so far been very limited. In this study, whole tissue sections from 130 bladder urothelial carcinoma and variants were stained with a panel of novel and traditional immunomarkers supportive of urothelial lineage. The positivity rates were as follows: a) urothelial carcinomas with or without divergent differentiation: GATA3 (50%), S100P (86%), uroplakin III (20%), thrombomodulin (40%), CK7 (80%), CK20 (55%), p63 (87%) and HMCK (89%); b) urothelial carcinoma variants (micropapillary, plasmacytoid, nested, clear cell and microcystic): GATA3 (88%), S100P (96%), uroplakin III (33%), thrombomodulin (49%), CK7 (95%), CK20 (61%), p63 (69%) and HMCK (96%); and c) undifferentiated carcinomas (LELC, small cell carcinoma, sarcomatoid carcinoma and carcinoma with rhabdoid and giant cells): GATA3 (28%), S100P (31%), uroplakin III (0%), thrombomodulin (22%), CK7 (50%), CK20 (3%), p63 (50%) and HMCK (49%). In urothelial carcinoma with squamous differentiation, GATA3 expression was lower (20%) in contrast to p63 and S100P. In urothelial carcinoma with glandular differentiation, GATA3 (50%) and p63 (60%) expression was lower than S100P (100%). p63 expression was relatively lower in micropapillary (54%) and plasmacytoid (50%) variants compared to the other urothelial carcinoma variants. This study provides a comprehensive data for novel and traditionally used markers to support urothelial lineage in urothelial carcinoma variants. Our findings show that GATA3, S100P, CK7, CK20, HMCK and p63, in the appropriate differential diagnostic setting, are useful to support urothelial lineage of variant morphologies.
    Human pathology 07/2014; 45(7). DOI:10.1016/j.humpath.2014.02.024 · 2.81 Impact Factor
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    ABSTRACT: Background. Microcystic variant of urothelial carcinoma is one of the new variants of urothelial carcinoma that was added to the WHO classification in 2004. Aims. To review the literature on microcystic variant of urothelial carcinoma. Methods. Various internet search engines were used to identify reported cases of the tumour. Results. Microscopic features of the tumour include: (i) Conspicuous intracellular and intercellular lumina/microcysts encompassed by malignant urothelial or squamous cells. (ii) The lumina are usually empty; may contain granular eosinophilic debris, mucin, or necrotic cells. (iii) The cysts may be variable in size; round, or oval, up to 2 mm; lined by urothelium which are either flattened cells or low columnar cells however, they do not contain colonic epithelium or goblet cells; are infiltrative; invade the muscularis propria; mimic cystitis cystica and cystitis glandularis; occasionally exhibit neuroendocrine differentiation. (iv) Elongated and irregular branching spaces are usually seen. About 17 cases of the tumour have been reported with only 2 patients who have survived. The tumour tends to be of high-grade and high-stage. There is no consensus opinion on the best option of treatment of the tumour. Conclusions. It would prove difficult at the moment to be dogmatic regarding its prognosis but it is a highly aggressive tumour. New cases of the tumour should be reported in order to document its biological behaviour.
    Advances in Urology 12/2013; 2013:654751. DOI:10.1155/2013/654751

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