Skip to main content
SpringerLink
Log in

Other Types of Carcinoma

  • Chapter
  • First Online:
Urinary Bladder Pathology

  • 750 Accesses

Abstract

As a vast majority of bladder cancers (over 90% in Western countries) are urothelial carcinoma in histology, non-urothelial carcinomas, such as squamous cell carcinoma (SCC) and adenocarcinoma, often present diagnostic and therapeutic challenges. SCC can occur in both non-bilharzial- and bilharzial-related bladders; the two subtypes differ in epidemiology, pathogenesis, and clinicopathological features. In addition, SCC of the bladder can present as several histological variants including verrucous, basaloid, and sarcomatoid SCCs. Primary adenocarcinoma of the urinary bladder is also an uncommon neoplasm, histologically subdivided into enteric, mucinous, not otherwise specified, and mixed types. These primary adenocarcinomas frequently become a source of diagnostic confusion with adenocarcinomas secondarily involving the bladder from the adjacent organs, such as the colon, prostate, and female genital tract. Urachal adenocarcinoma is usually discussed together with bladder adenocarcinoma, because they share many clinical and histological features. The 2016 World Health Organization classification delineates urachal glandular tumors into two broad categories: mucinous cystic tumors and non-cystic adenocarcinomas. Clear cell carcinoma (tumor of the Müllerian type) primarily arising from the urinary bladder, a distinct form of non-urothelial carcinoma, is also discussed in this chapter.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Shen SS, Al-Ahmadie H, Mahfouz SM. Squamous cell neoplasms. Tumours of the urinary system. In: Moch H, Humphrey PA, Ulbright TM, Reuter VE, editors. World Health Organization classification of tumours of the urinary system and male genital organs. Lyon: IARC Press; 2016. p. 108–10.

    Google Scholar 

  2. Johnson DE, Schoenwald MB, Ayala AG, Miller LS. Squamous cell carcinoma of the bladder. J Urol. 1976;115:542–4.

    Article  CAS  PubMed  Google Scholar 

  3. Rundle JS, Hart AJ, McGeorge A, Smith JS, Malcolm AJ, Smith PM. Squamous cell carcinoma of bladder. A review of 114 patients. Br J Urol. 1982;54:522–6.

    Article  CAS  PubMed  Google Scholar 

  4. Shokeir AA. Squamous cell carcinoma of the bladder: pathology, diagnosis and treatment. BJU Int. 2004;93:216–20.

    Article  CAS  PubMed  Google Scholar 

  5. Gschwend JE, Dahm P, Fair WR. Disease specific survival as endpoint of outcome for bladder cancer patients following radical cystectomy. Eur Urol. 2002;41:440–8.

    Article  PubMed  Google Scholar 

  6. Ghoneim MA, el-Mekresh MM, el-Baz MA, el-Attar IA, Ashamallah A. Radical cystectomy for carcinoma of the bladder: critical evaluation of the results in 1,026 cases. J Urol. 1997;158:393–9.

    Article  CAS  PubMed  Google Scholar 

  7. Salem HK, Mahfouz S. Changing patterns (age, incidence, and pathologic types) of schistosoma-associated bladder cancer in Egypt in the past decade. Urology. 2012;79:379–83.

    Article  PubMed  Google Scholar 

  8. El-Bolkainy MN, Ghoneim MA, Mansour MA. Carcinoma of the bilharzial bladder in Egypt: clinical and pathological features. Br J Urol. 1972;44:561–9.

    Article  Google Scholar 

  9. El-Sebai I, Sherif M, El-Bolkainy MN, Mansour MA, Ghoneim MA. Verrucous squamous carcinoma of bladder. Urology. 1974;4:407–10.

    Article  CAS  PubMed  Google Scholar 

  10. Bejany DE, Lockhart JL, Rhamy RK. Malignant vesical tumors following spinal cord injury. J Urol. 1987;138:1390–2.

    Article  CAS  PubMed  Google Scholar 

  11. Pannek J. Transitional cell carcinoma in patients with spinal cord injury: a high-risk malignancy? Urology. 2002;59:240–4.

    Article  PubMed  Google Scholar 

  12. Brenner DW, Yore LM, Schellhammer PF. Squamous cell carcinoma of bladder after successful intravesical therapy with Bacillus Calmette-Guérin. Urology. 1989;34:93–5.

    Article  CAS  PubMed  Google Scholar 

  13. El-Aaser AA, El-Merzabani MM, Higgy NA, Kader MM. A study on the aetiological factors of bilharzial bladder cancer in Egypt. 3. Urinary beta-glucuronidase. Eur J Cancer. 1979;15:573–83.

    Article  CAS  PubMed  Google Scholar 

  14. Khales HM. Bladder cancer and bilharziasis today. Cancer J. 1993;6:65–71.

    Google Scholar 

  15. El-Said A, Omar S, Ibrahim S, Tawfik H, Eissa S, Ali S, et al. Bilharzial bladder cancer in Egypt, a review of 420 cases of radical cystectomy. Jpn J Clin Oncol. 1979;9:117–22.

    Google Scholar 

  16. Khafagy MM, El-Bolkainy MN, Mansour MA. Carcinoma of the bilharzial urinary bladder. A study of the associated mucosal lesions in 86 cases. Cancer. 1972;30:150–9.

    Article  CAS  PubMed  Google Scholar 

  17. Serretta V, Pomara G, Piazza F, Gange E. Pure squamous cell carcinoma of the bladder in western countries. Report on 19 consecutive cases. Eur Urol. 2000;37:85–9.

    Article  CAS  PubMed  Google Scholar 

  18. Lagwinski N, Thomas A, Stephenson AJ, Campbell S, Hoschar AP, El-Gabry E, et al. Squamous cell carcinoma of the bladder: a clinicopathologic analysis of 45 cases. Am J Surg Pathol. 2007;31:1777–87.

    Article  PubMed  Google Scholar 

  19. Khalaf I, Shokeir A, Shalaby M. Urologic complications of genitourinary schistosomiasis. World J Urol. 2012;30:31–8.

    Article  PubMed  Google Scholar 

  20. Richie JP, Waisman J, Skinner DG, Dretler SP. Squamous carcinoma of the bladder: treatment by radical cystectomy. J Urol. 1976;115:670–2.

    Article  CAS  PubMed  Google Scholar 

  21. Ghomneim MA, Mansour MA, El-Bolkainy MN. Staging of carcinoma of bilharzial bladder. Urology. 1974;3:40–2.

    Article  Google Scholar 

  22. Wishnow KI, Dmochowski R. Pelvic recurrence after radical cystectomy without preoperative radiation. J Urol. 1988;140:42–3.

    Article  CAS  PubMed  Google Scholar 

  23. Aly MS, Khaled HM. Chromosomal aberrations in early stage bilharzial bladder cancer. Cancer Genet Cytogenet. 2002;132:41–5.

    Article  CAS  PubMed  Google Scholar 

  24. Fadl-Elmula I, Kytola S, Leithy ME, Abdel-Hameed M, Mandahl N, Elagib A, et al. Chromosomal aberrations in benign and malignant bilharzia-associated bladder lesions analyzed by comparative genomic hybridization. BMC Cancer. 2002;2:5.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Gonzalez-Zulueta M. Tumor suppressor gene alterations in squamous cell carcinoma of the bladder. J Natl Cancer Inst. 1995;87:1383–93.

    Article  CAS  PubMed  Google Scholar 

  26. El-Rifai W, Kamel D, Larramendy ML, Shoman S, Gad Y, Baithun S, et al. DNA copy number changes in Schistosoma-associated and non-Schistosoma-associated bladder cancer. Am J Pathol. 2000;156:871–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Molitor M, Junker K, Eltze E, Toma M, Denzinger S, Siegert S, et al. Comparison of structural genetics of non-Schistosoma-associated squamous cell carcinoma of the urinary bladder. Int J Clin Exp Pathol. 2015;8:8143–58.

    PubMed  PubMed Central  Google Scholar 

  28. Cowan M, Springer S, Nguyen D, Taheri D, Guner G, Rodriguez MA, et al. High prevalence of TERT promoter mutations in primary squamous cell carcinoma of the urinary bladder. Mod Pathol. 2016;29:511–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Ramchurren N, Cooper K, Summerhayes IC. Molecular events underlying schistosomiasis-related bladder cancer. Int J Cancer. 1995;62:237–44.

    Article  CAS  PubMed  Google Scholar 

  30. Warren W, Biggs PJ, el-Baz M, Ghoneim MA, Stratton MR, Venitt S. Mutations in the p53 gene in schistosomal bladder cancer: a study of 92 tumours from Egyptian patients and a comparison between mutational spectra from schistosomal and non-schistosomal urothelial tumours. Carcinogenesis. 1995;16:1181–9.

    Article  CAS  PubMed  Google Scholar 

  31. Abdulamir AS, Hafidh RR, Kadhim HS, Abubakar F. Tumor markers of bladder cancer: the schistosomal bladder tumors versus non-schistosomal bladder tumors. J Exp Clin Cancer Res. 2009;28:27.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Bue P, Wester K, Sjöström A, Holmberg A, Nilsson S, Carlsson J, et al. Expression of epidermal growth factor receptor in urinary bladder cancer metastases. Int J Cancer. 1998;76:189–93.

    Article  CAS  PubMed  Google Scholar 

  33. Berner A, Jacobsen AB, Fosså SD, Nesland JM. Expression of c-erbB-2 protein, neuron-specific enolase and DNA flow cytometry in locally advanced transitional cell carcinoma of the urinary bladder. Histopathology. 1993;22:327–33.

    Article  CAS  PubMed  Google Scholar 

  34. Swanson DA, Liles A, Zagars GK. Preoperative irradiation and radical cystectomy for stages T2 and T3 squamous cell carcinoma of the bladder. J Urol. 1990;143:37–40.

    Article  CAS  PubMed  Google Scholar 

  35. Ghoneim MA, Ashamallah AK, Awaad HK, Whitmore WF Jr. Randomized trial of cystectomy with or without preoperative radiotherapy for carcinoma of the bilharzial bladder. J Urol. 1985;134:266–8.

    Article  CAS  PubMed  Google Scholar 

  36. Elsobky E, El-Baz M, Gomha M, Abol-Enein H, Shaaban AA. Prognostic value of angiogenesis in schistosoma-associated squamous cell carcinoma of the urinary bladder. Urology. 2002;60:69–77.

    Article  PubMed  Google Scholar 

  37. Vakar-López F, Abrams J. Basaloid squamous cell carcinoma occurring in the urinary bladder. Arch Pathol Lab Med. 2000;124:455–9.

    Article  PubMed  Google Scholar 

  38. Neves TR, Soares MJ, Monteiro PG, Lima MS, Monteiro HG. Basaloid squamous cell carcinoma in the urinary bladder with small-cell carcinoma. J Clin Oncol. 2011;29:440–2.

    Article  Google Scholar 

  39. Ginori A, Barone A, Santopietro R, Barbanti G, Cecconi F, Tripodi SA. Human papillomavirus-related basaloid squamous cell carcinoma of the bladder associated with genital tract human papillomavirus infection. Int J Urol. 2015;22:222–5.

    Article  PubMed  Google Scholar 

  40. Ishida M, Iwai M, Yoshida K, Kagotani A, Okabe H. Sarcomatoid carcinoma with small cell carcinoma component of the urinary bladder: a case report with review of the literature. Int J Clin Exp Pathol. 2013;6:1671–6.

    PubMed  PubMed Central  Google Scholar 

  41. Abrahams NA, Moran C, Reyes AO, Siefker-Radtke A, Ayala AG. Small cell carcinoma of the bladder: a contemporary clinicopathological study of 51 cases. Histopathology. 2005;46:57–63.

    Article  CAS  PubMed  Google Scholar 

  42. Grignon DJ, Cheville J, Ro JY, Tamboli P. Glandular neoplasms. Tumours of the urinary system. In: Moch H, Humphrey PA, Ulbright TM, Reuter VE, editors. World Health Organization classification of tumours of the urinary system and male genital organs. Lyon: IARC Press; 2016. p. 111–2.

    Google Scholar 

  43. Grignon DJ, Ro JY, Ayala AG, Johnson DE, Ordóñez NG. Primary adenocarcinoma of the urinary bladder. A clinicopathologic analysis of 72 cases. Cancer. 1991;67:2165–72.

    Article  CAS  PubMed  Google Scholar 

  44. Grignon DJ, Ro JY, Ayala AG, Johnson DE. Primary signet-ring cell carcinoma of the urinary bladder. Am J Clin Pathol. 1991;95:13–20.

    Article  CAS  PubMed  Google Scholar 

  45. Roy S, Pradhan D, Ernst WL, Mercurio S, Najjar Y, Parikh R, et al. Next-generation sequencing-based molecular characterization of primary urinary bladder adenocarcinoma. Mod Pathol. 2017;30:1133–43.

    Article  CAS  PubMed  Google Scholar 

  46. Cowan ML, Springer S, Nguyen D, Taheri D, Guner G, Mendoza Rodriguez MA, et al. Detection of TERT promoter mutations in primary adenocarcinoma of the urinary bladder. Hum Pathol. 2016;53:8–13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Zaghloul MS, Nouh A, Nazmy M, Ramzy S, Zaghloul AS, Sedira MA, et al. Long-term results of primary adenocarcinoma of the urinary bladder: a report on 192 patients. Urol Oncol. 2006;24:13–20.

    Article  PubMed  Google Scholar 

  48. el-Mekresh MM, el-Baz MA, Abol-Enein H, Ghoneim MA. Primary adenocarcinoma of the urinary bladder: a report of 185 cases. Br J Urol. 1998;82:206–12.

    Article  CAS  PubMed  Google Scholar 

  49. Rao Q, Williamson SR, Lopez-Beltran A, Montironi R, Huang W, Eble JN, et al. Distinguishing primary adenocarcinoma of the urinary bladder from secondary involvement by colorectal adenocarcinoma: extended immunohistochemical profiles emphasizing novel markers. Mod Pathol. 2013;26:725–32.

    Article  CAS  PubMed  Google Scholar 

  50. Dadhania V, Czerniak B, Guo CC. Adenocarcinoma of the urinary bladder. Am J Clin Exp Urol. 2015;3:51–63.

    PubMed  PubMed Central  Google Scholar 

  51. Epstein JI, Egevad L, Humphrey PA, Montironi R, Members of the ISUP Immunohistochemistry in Diagnostic Urologic Pathology Group. Best practices recommendations in the application of immunohistochemistry in the prostate: report from the International Society of Urologic Pathology consensus conference. Am J Surg Pathol. 2014;38:e6–e19.

    Article  PubMed  Google Scholar 

  52. Morichetti D, Mazzucchelli R, Lopez-Beltran A, Cheng L, Scarpelli M, Kirkali Z, et al. Secondary neoplasms of the urinary system and male genital organs. BJU Int. 2009;104:770–6.

    Article  PubMed  Google Scholar 

  53. Schubert GE, Pavkovic MB, Bethke-Bedürftig BA. Tubular urachal remnants in adult bladders. J Urol. 1982;127:40–2.

    Article  CAS  PubMed  Google Scholar 

  54. Gopalan A, Sharp DS, Fine SW, Tickoo SK, Herr HW, Reuter VE, et al. Urachal carcinoma: a clinicopathologic analysis of 24 cases with outcome correlation. Am J Surg Pathol. 2009;33:659–68.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Amin MB, Smith SC, Eble JN, Rao P, Choi WW, Tamboli P, et al. Glandular neoplasms of the urachus: a report of 55 cases emphasizing mucinous cystic tumors with proposed classification. Am J Surg Pathol. 2014;38:1033–45.

    Article  PubMed  Google Scholar 

  56. Paner GP, Lopez-Beltran A, Sirohi D, Amin MB. Updates in the pathologic diagnosis and classification of epithelial neoplasms of urachal origin. Adv Anat Pathol. 2016;23:71–83.

    Article  CAS  PubMed  Google Scholar 

  57. Paner GP, McKenney JK, Barkan GA, Yao JL, Frankel WL, Sebo TJ, et al. Immunohistochemical analysis in a morphologic spectrum of urachal epithelial neoplasms: diagnostic implications and pitfalls. Am J Surg Pathol. 2011;35:787–98.

    Article  PubMed  Google Scholar 

  58. Módos O, Reis H, Niedworok C, Rübben H, Szendröi A, Szász MA, et al. Mutations of KRAS, NRAS, BRAF, EGFR, and PIK3CA genes in urachal carcinoma: occurrence and prognostic significance. Oncotarget. 2016;7:39293–301.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Lee S, Lee J, Sim SH, Lee Y, Moon KC, Lee C, et al. Comprehensive somatic genome alterations of urachal carcinoma. J Med Genet. 2017;54:572–8.

    Article  CAS  PubMed  Google Scholar 

  60. Singh H, Liu Y, Xiao X, Lin L, Kim J, Van Hummelen P, et al. Whole exome sequencing of urachal adenocarcinoma reveals recurrent NF1 mutations. Oncotarget. 2016;7:29211–5.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Thiem S, Herold T, Krafft U, Bremmer F, Tolkach Y, Szász AM, et al. Telomerase reverse transcriptase (TERT) promoter mutations are rare in urachal cancer. Pathol Int. 2017;67:597–601.

    Article  CAS  PubMed  Google Scholar 

  62. Wright JL, Porter MP, Li CI, Lange PH, Lin DW. Differences in survival among patients with urachal and nonurachal adenocarcinomas of the bladder. Cancer. 2006;107:721–8.

    Article  PubMed  Google Scholar 

  63. Sheldon CA, Clayman RV, Gonzalez R, Williams RD, Fraley EE. Malignant urachal lesions. J Urol. 1984;131:1–8.

    Article  CAS  PubMed  Google Scholar 

  64. Molina JR, Quevedo JF, Furth AF, Richardson RL, Zincke H, Burch PA. Predictors of survival from urachal cancer: a Mayo Clinic study of 49 cases. Cancer. 2007;110:2434–40.

    Article  PubMed  Google Scholar 

  65. Pinthus JH, Haddad R, Trachtenberg J, Holowaty E, Bowler J, Herzenberg AM, et al. Population based survival data on urachal tumors. J Urol. 2006;175:2042–7.

    Article  PubMed  Google Scholar 

  66. Herr HW, Bochner BH, Sharp D, Dalbagni G, Reuter VE. Urachal carcinoma: contemporary surgical outcomes. J Urol. 2007;178:74–8.

    Article  PubMed  Google Scholar 

  67. Oliva E, Amin MB, Jimenez R, Young RH. Clear cell carcinoma of the urinary bladder: a report and comparison of four tumors of Mullerian origin and nine of probable urothelial origin with discussion of histogenesis and diagnostic problems. Am J Surg Pathol. 2002;26:190–7.

    Article  PubMed  Google Scholar 

  68. Gilcrease MZ, Delgado R, Vuitch F, Albores-Saavedra J. Clear cell adenocarcinoma and nephrogenic adenoma of the urethra and urinary bladder: a histopathologic and immunohistochemical comparison. Hum Pathol. 1998;29:1451–6.

    Article  CAS  PubMed  Google Scholar 

  69. Tong GX, Weeden EM, Hamele-Bena D, Huan Y, Unger P, Memeo L, et al. Expression of PAX8 in nephrogenic adenoma and clear cell adenocarcinoma of the lower urinary tract: evidence of related histogenesis? Am J Surg Pathol. 2008;32:1380–7.

    Article  PubMed  Google Scholar 

  70. Jassim SH, Khiyami A, Nguyen JK, Ganesan S, Tomashefski J Jr, Sawady J. Concordant clear cell “mesonephric” carcinoma of the bladder and lung adenocarcinoma with clear cell features – multiple primaries versus metastatic neoplasms: a case report. J Med Case Rep. 2017;11:133.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Oliva E, Young RH. Nephrogenic adenoma of the urinary tract: a review of the microscopic appearance of 80 cases with emphasis on unusual features. Mod Pathol. 1995;8:722–30.

    CAS  PubMed  Google Scholar 

  72. Young RH. Tumor-like lesions of the urinary bladder. Mod Pathol. 2009;22:S37–52.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. National Defense Medical College, Department of Basic Pathology, Saitama, Japan

    Kosuke Miyai

  2. Department of Pathology, First Medical Lab, Amman, Jordan

    Hussam Abu-Farsakh

  3. Department of Pathology and Genomic Medicine, Weill Medical College of Cornell University/Houston Methodist Hospital, Houston, TX, USA

    Jae Y. Ro

Authors
  1. Kosuke Miyai
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hussam Abu-Farsakh
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jae Y. Ro
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kosuke Miyai .

Editor information

Editors and Affiliations

  1. Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX, USA

    Haijun Zhou

  2. Department of Pathology, MD Anderson Cancer Center, Houston, TX, USA

    Charles C. Guo

  3. Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX, USA

    Jae Y. Ro

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Miyai, K., Abu-Farsakh, H., Ro, J.Y. (2021). Other Types of Carcinoma. In: Zhou, H., Guo, C.C., Ro, J.Y. (eds) Urinary Bladder Pathology. Springer, Cham. https://doi.org/10.1007/978-3-030-71509-0_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-71509-0_7

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-71508-3

  • Online ISBN: 978-3-030-71509-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation