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Urothelial Carcinoma Variants: Morphology and Association with Outcomes

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Abstract

During these past few decades, several uncommon and unique variants of urothelial carcinoma have been described. These variants’ morphologies constitute < 5 % of bladder carcinomas and may occur in pure form, or more often, are admixed with conventional urothelial carcinoma. Most tumors are recognized descriptively according to their unique histo- or cyto-morphology such as nested, microcystic, micropapillary, plasmacytoid, clear cell, and lymphoepithelioma-like carcinoma variants. Awareness of these variants is important as some are suggested to have an aggressive behavior and differing therapeutic response when compared to conventional urothelial carcinoma. Some may also have a unique presentation and pattern of tumor spread. Further, since these variants have distinct morphology from conventional urothelial carcinoma, they may histologically resemble benign processes or tumors of other organ primaries. Diagnosis of urothelial carcinoma variants may pose a challenge particularly in bladder biopsies or at metastatic sites.

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References

  1. Eble JN, Sauter G, Epstein JI, Sesterhenn IA, editors. Pathology and genetics of tumours of the urinary system and male genital organs. Lyon: IARC Press; 2004.

    Google Scholar 

  2. Amin MB. Histological variants of urothelial carcinoma: diagnostic, therapeutic and prognostic implications. Mod Pathol. 2009;22(Suppl 2):S96–118.

    PubMed  Google Scholar 

  3. Lopez-Beltran A, Requena MJ, Cheng L, Montironi R. Pathological variants of invasive bladder cancer according to their suggested clinical significance. BJU Int. 2008;101(3):275–81.

    PubMed  Google Scholar 

  4. Bladder Cancer. 2nd international consultation on bladder cancer—Vienna. Vienna: EDITIONS 21; 2012.

    Google Scholar 

  5. 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(12):1777–87.

    PubMed  Google Scholar 

  6. Abd El-Latif A, Watts KE, Elson P, Fergany A, Hansel DE. The sensitivity of initial transurethral resection or biopsy of bladder tumor(s) for detecting bladder cancer variants on radical cystectomy. J Urol. 2013;189(4):1263–7.

    PubMed  Google Scholar 

  7. Gulmann C, Paner GP, Parakh RS, Hansel DE, Shen SS, Ro JY, et al. Immunohistochemical profile to distinguish urothelial from squamous differentiation in carcinomas of urothelial tract. Hum Pathol. 2013;44(2):164–72.

    CAS  PubMed  Google Scholar 

  8. Gruver AM, Amin MB, Luthringer DJ, Westfall D, Arora K, Farver CF, et al. Selective immunohistochemical markers to distinguish between metastatic high-grade urothelial carcinoma and primary poorly differentiated invasive squamous cell carcinoma of the lung. Arch Pathol Lab Med. 2012;136(11):1339–46.

    PubMed  Google Scholar 

  9. Antunes AA, Nesrallah LJ, Dall’Oglio MF, Maluf CE, Camara C, Leite KR, et al. The role of squamous differentiation in patients with transitional cell carcinoma of the bladder treated with radical cystectomy. Int Braz J Urol. 2007;33(3):339–45; discussion 46.

    PubMed  Google Scholar 

  10. Rogers CG, Palapattu GS, Shariat SF, Karakiewicz PI, Bastian PJ, Lotan Y, et al. Clinical outcomes following radical cystectomy for primary nontransitional cell carcinoma of the bladder compared to transitional cell carcinoma of the bladder. J Urol. 2006;175(6):2048–53; discussion 53.

    PubMed  Google Scholar 

  11. Martin JE, Jenkins BJ, Zuk RJ, Blandy JP, Baithun SI. Clinical importance of squamous metaplasia in invasive transitional cell carcinoma of the bladder. J Clin Pathol. 1989;42(3):250–3.

    PubMed Central  CAS  PubMed  Google Scholar 

  12. Black PC, Brown GA, Dinney CP. The impact of variant histology on the outcome of bladder cancer treated with curative intent. Urol Oncol. 2009;27(1):3–7.

    PubMed  Google Scholar 

  13. Scosyrev E, Ely BW, Messing EM, Speights VO, Grossman HB, Wood DP, et al. Do mixed histological features affect survival benefit from neoadjuvant platinum-based combination chemotherapy in patients with locally advanced bladder cancer? A secondary analysis of Southwest oncology group-directed intergroup study (S8710). BJU Int. 2011;108(5):693–9.

    PubMed Central  CAS  PubMed  Google Scholar 

  14. Logothetis CJ, Dexeus FH, Chong C, Sella A, Ayala AG, Ro JY, et al. Cisplatin, cyclophosphamide and doxorubicin chemotherapy for unresectable urothelial tumors: the M.D. Anderson experience. J Urol. 1989;141(1):33–7.

    CAS  PubMed  Google Scholar 

  15. Lin O, Cardillo M, Dalbagni G, Linkov I, Hutchinson B, Reuter VE. Nested variant of urothelial carcinoma: a clinicopathologic and immunohistochemical study of 12 cases. Mod Pathol. 2003;16(12):1289–98.

    PubMed  Google Scholar 

  16. Linder BJ, Frank I, Cheville JC, Thompson RH, Thapa P, Tarrell RF, et al. Outcomes following radical cystectomy for nested variant of urothelial carcinoma: a matched cohort analysis. J Urol. 2013;189(5):1670–5.

    PubMed  Google Scholar 

  17. Wasco MJ, Daignault S, Bradley D, Shah RB. Nested variant of urothelial carcinoma: a clinicopathologic and immunohistochemical study of 30 pure and mixed cases. Hum Pathol. 2010;41(2):163–71.

    PubMed  Google Scholar 

  18. Volmar KE, Chan TY, De Marzo AM, Epstein JI. Florid von Brunn nests mimicking urothelial carcinoma: a morphologic and immunohistochemical comparison to the nested variant of urothelial carcinoma. Am J Surg Pathol. 2003;27(9):1243–52.

    PubMed  Google Scholar 

  19. Holmang S, Johansson SL. The nested variant of transitional cell carcinoma—a rare neoplasm with poor prognosis. Scand J Urol Nephrol. 2001;35(2):102–5.

    CAS  PubMed  Google Scholar 

  20. Drew PA, Furman J, Civantos F, Murphy WM. The nested variant of transitional cell carcinoma: an aggressive neoplasm with innocuous histology. Mod Pathol. 1996;9(10):989–94.

    CAS  PubMed  Google Scholar 

  21. Dhall D, Al-Ahmadie H, Olgac S. Nested variant of urothelial carcinoma. Arch Pathol Lab Med. 2007;131(11):1725–7.

    PubMed  Google Scholar 

  22. Liedberg F, Chebil G, Davidsson T, Gadaleanu V, Grabe M, Mansson W. The nested variant of urothelial carcinoma: a rare but important bladder neoplasm with aggressive behavior. Three case reports and a review of the literature. Urol Oncol. 2003;21(1):7–9.

    PubMed  Google Scholar 

  23. Xiao GQ, Savage SJ, Gribetz ME, Burstein DE, Miller LK, Unger PD. The nested variant of urothelial carcinoma: clinicopathology of 2 cases. Arch Pathol Lab Med. 2003;127(8):e333–6.

    PubMed  Google Scholar 

  24. Talbert ML, Young RH. Carcinomas of the urinary bladder with deceptively benign-appearing foci. A report of three cases. Am J Surg Pathol. 1989;13(5):374–81.

    CAS  PubMed  Google Scholar 

  25. Cox R, Epstein JI. Large nested variant of urothelial carcinoma: 23 cases mimicking von Brunn nests and inverted growth pattern of noninvasive papillary urothelial carcinoma. Am J Surg Pathol. 2011;35(9):1337–42.

    PubMed  Google Scholar 

  26. Young RH, Oliva E. Transitional cell carcinomas of the urinary bladder that may be underdiagnosed. A report of four invasive cases exemplifying the homology between neoplastic and non-neoplastic transitional cell lesions. Am J Surg Pathol. 1996;20(12):1448–54.

    CAS  PubMed  Google Scholar 

  27. Sari A, Uyaroglu MA, Ermete M, Oder M, Girgin C, Dincer C. Microcystic urothelial carcinoma of the urinary bladder metastatic to the penis. Pathol Oncol Res. 2007;13(2):170–3.

    PubMed  Google Scholar 

  28. Leroy X, Leteurtre E, De La Taille A, Augusto D, Biserte J, Gosselin B. Microcystic transitional cell carcinoma: a report of 2 cases arising in the renal pelvis. Arch Pathol Lab Med. 2002;126(7):859–61.

    PubMed  Google Scholar 

  29. Paz A, Rath-Wolfson L, Lask D, Koren R, Manes A, Mukamel E, et al. The clinical and histological features of transitional cell carcinoma of the bladder with microcysts: analysis of 12 cases. Br J Urol. 1997;79(5):722–5.

    CAS  PubMed  Google Scholar 

  30. Young RH, Zukerberg LR. Microcystic transitional cell carcinomas of the urinary bladder. A report of four cases. Am J Clin Pathol. 1991;96(5):635–9.

    CAS  PubMed  Google Scholar 

  31. Zhai QJ, Black J, Ayala AG, Ro JY. Histologic variants of infiltrating urothelial carcinoma. Arch Pathol Lab Med. 2007;131(8):1244–56.

    PubMed  Google Scholar 

  32. Huang Q, Chu PG, Lau SK, Weiss LM. Urothelial carcinoma of the urinary bladder with a component of acinar/tubular type differentiation simulating prostatic adenocarcinoma. Hum Pathol. 2004;35(6):769–73.

    PubMed  Google Scholar 

  33. Kamat AM, Dinney CP, Gee JR, Grossman HB, Siefker-Radtke AO, Tamboli P, et al. Micropapillary bladder cancer: a review of the University of Texas M. D. Anderson Cancer Center experience with 100 consecutive patients. Cancer. 2007;110(1):62–7.

    PubMed  Google Scholar 

  34. Amin MB, Ro JY, el-Sharkawy T, Lee KM, Troncoso P, Silva EG, et al. Micropapillary variant of transitional cell carcinoma of the urinary bladder. Histologic pattern resembling ovarian papillary serous carcinoma. Am J Surg Pathol. 1994;18(12):1224–32.

    CAS  PubMed  Google Scholar 

  35. Perepletchikov AM, Parwani AV. Micropapillary urothelial carcinoma: clinico-pathologic review. Pathol Res Pract. 2009;205(12):807–10.

    PubMed  Google Scholar 

  36. Guo CC, Tamboli P, Czerniak B. Micropapillary variant of urothelial carcinoma in the upper urinary tract: a clinicopathologic study of 11 cases. Arch Pathol Lab Med. 2009;133(1):62–6.

    PubMed  Google Scholar 

  37. Sangoi AR, Beck AH, Amin MB, Cheng L, Epstein JI, Hansel DE, et al. Interobserver reproducibility in the diagnosis of invasive micropapillary carcinoma of the urinary tract among urologic pathologists. Am J Surg Pathol. 2010;34(9):1367–76.

    PubMed  Google Scholar 

  38. Comperat E, Roupret M, Yaxley J, Reynolds J, Varinot J, Ouzaid I, et al. Micropapillary urothelial carcinoma of the urinary bladder: a clinicopathological analysis of 72 cases. Pathology. 2010;42(7):650–4.

    PubMed  Google Scholar 

  39. Gaya JM, Palou J, Algaba F, Arce J, Rodriguez-Faba O, Villavicencio H. The case for conservative management in the treatment of patients with non-muscle-invasive micropapillary bladder carcinoma without carcinoma in situ. Can J Urol. 2010;17(5):5370–6.

    PubMed  Google Scholar 

  40. Lotan TL, Ye H, Melamed J, Wu XR, Shih Ie M, Epstein JI. Immunohistochemical panel to identify the primary site of invasive micropapillary carcinoma. Am J Surg Pathol. 2009;33(7):1037–41.

    PubMed Central  PubMed  Google Scholar 

  41. Nassar H, Pansare V, Zhang H, Che M, Sakr W, Ali-Fehmi R, et al. Pathogenesis of invasive micropapillary carcinoma: role of MUC1 glycoprotein. Mod Pathol. 2004;17(9):1045–50.

    CAS  PubMed  Google Scholar 

  42. Sangoi AR, Higgins JP, Rouse RV, Schneider AG, McKenney JK. Immunohistochemical comparison of MUC1, CA125, and Her2Neu in invasive micropapillary carcinoma of the urinary tract and typical invasive urothelial carcinoma with retraction artifact. Mod Pathol. 2009;22(5):660–7.

    CAS  PubMed  Google Scholar 

  43. Kamat AM, Gee JR, Dinney CP, Grossman HB, Swanson DA, Millikan RE, et al. The case for early cystectomy in the treatment of nonmuscle invasive micropapillary bladder carcinoma. J Urol. 2006;175(3 Pt 1):881–5.

    PubMed  Google Scholar 

  44. Spaliviero M, Dalbagni G, Bochner BH, Poon BY, Huang H, Al-Ahmadie HA, et al. Clinical outcome of patients with T1 micropapillary urothelial carcinoma of the bladder. J Urol. 2014;192(3):702–7. doi:10.1016/j.juro.2014.02.2565.

    PubMed  Google Scholar 

  45. Keck B, Wach S, Stoehr R, Kunath F, Bertz S, Lehmann J, et al. Plasmacytoid variant of bladder cancer defines patients with poor prognosis if treated with cystectomy and adjuvant cisplatin-based chemotherapy. BMC Cancer. 2013;13:71.

    PubMed Central  CAS  PubMed  Google Scholar 

  46. Keck B, Stoehr R, Wach S, Rogler A, Hofstaedter F, Lehmann J, et al. The plasmacytoid carcinoma of the bladder—rare variant of aggressive urothelial carcinoma. Int J Cancer. 2011;129(2):346–54.

    CAS  PubMed  Google Scholar 

  47. Dayyani F, Czerniak BA, Sircar K, Munsell MF, Millikan RE, Dinney CP, et al. Plasmacytoid urothelial carcinoma, a chemosensitive cancer with poor prognosis, and peritoneal carcinomatosis. J Urol. 2013;189(5):1656–61.

    PubMed Central  PubMed  Google Scholar 

  48. Ricardo-Gonzalez RR, Nguyen M, Gokden N, Sangoi AR, Presti JC Jr, McKenney JK. Plasmacytoid carcinoma of the bladder: a urothelial carcinoma variant with a predilection for intraperitoneal spread. J Urol. 2012;187(3):852–5.

    PubMed  Google Scholar 

  49. Raspollini MR, Sardi I, Giunti L, Di Lollo S, Baroni G, Stomaci N, et al. Plasmacytoid urothelial carcinoma of the urinary bladder: clinicopathologic, immunohistochemical, ultrastructural, and molecular analysis of a case series. Hum Pathol. 2011;42(8):1149–58.

    CAS  PubMed  Google Scholar 

  50. Nigwekar P, Tamboli P, Amin MB, Osunkoya AO, Ben-Dor D, Amin MB. Plasmacytoid urothelial carcinoma: detailed analysis of morphology with clinicopathologic correlation in 17 cases. Am J Surg Pathol. 2009;33(3):417–24.

    PubMed  Google Scholar 

  51. Lopez-Beltran A, Requena MJ, Montironi R, Blanca A, Cheng L. Plasmacytoid urothelial carcinoma of the bladder. Hum Pathol. 2009;40(7):1023–8.

    PubMed  Google Scholar 

  52. Ro JY, Shen SS, Lee HI, Hong EK, Lee YH, Cho NH, et al. Plasmacytoid transitional cell carcinoma of urinary bladder: a clinicopathologic study of 9 cases. Am J Surg Pathol. 2008;32(5):752–7.

    PubMed  Google Scholar 

  53. Fritsche HM, Burger M, Denzinger S, Legal W, Goebell PJ, Hartmann A. Plasmacytoid urothelial carcinoma of the bladder: histological and clinical features of 5 cases. J Urol. 2008;180(5):1923–7.

    CAS  PubMed  Google Scholar 

  54. Mai KT, Park PC, Yazdi HM, Saltel E, Erdogan S, Stinson WA, et al. Plasmacytoid urothelial carcinoma of the urinary bladder report of seven new cases. Eur Urol. 2006;50(5):1111–4.

    PubMed  Google Scholar 

  55. Gaafar A, Garmendia M, de Miguel E, Velasco V, Ugalde A, Bilbao FJ, et al. Plasmacytoid urothelial carcinoma of the urinary bladder. A study of 7 cases. Actas Urol Esp. 2008;32(8):806–10. Carcinoma urotelial plasmocitoide de vejiga urinaria. Estudio de 7 casos.

    CAS  PubMed  Google Scholar 

  56. Chang JH, Dikranian AH, Johnston WH, Storch SK, Hurwitz RS. Malignant extrarenal rhabdoid tumor of the bladder: 9-year survival after chemotherapy and partial cystectomy. J Urol. 2004; 171(2 Pt 1):820–1.

    PubMed  Google Scholar 

  57. Duvdevani M, Nass D, Neumann Y, Leibovitch I, Ramon J, Mor Y. Pure rhabdoid tumor of the bladder. J Urol. 2001;166(6):2337.

    CAS  PubMed  Google Scholar 

  58. Carter RL, McCarthy KP, al-Sam SZ, Monaghan P, Agrawal M, McElwain TJ. Malignant rhabdoid tumour of the bladder with immunohistochemical and ultrastructural evidence suggesting histiocytic origin. Histopathology. 1989;14(2):179–90.

    CAS  PubMed  Google Scholar 

  59. Harris M, Eyden BP, Joglekar VM. Rhabdoid tumour of the bladder: a histological, ultrastructural and immunohistochemical study. Histopathology. 1987;11(10):1083–92.

    CAS  PubMed  Google Scholar 

  60. Parwani AV, Herawi M, Volmar K, Tsay SH, Epstein JI. Urothelial carcinoma with rhabdoid features: report of 6 cases. Hum Pathol. 2006;37(2):168–72.

    PubMed  Google Scholar 

  61. Kojima Y, Takasawa A, Murata M, Akagashi K, Inoue T, Hara M, et al. A case of urothelial carcinoma, lipid cell variant. Pathol Int. 2013;63(3):183–7.

    PubMed  Google Scholar 

  62. Lopez-Beltran A, Amin MB, Oliveira PS, Montironi R, Algaba F, McKenney JK, et al. Urothelial carcinoma of the bladder, lipid cell variant: clinicopathologic findings and LOH analysis. Am J Surg Pathol. 2010;34(3):371–6.

    PubMed  Google Scholar 

  63. Shimada K, Nakamura M, Konishi N. A case of urothelial carcinoma with triple variants featuring nested, plasmacytoid, and lipoid cell morphology. Diagn Cytopathol. 2009;37(4):272–6.

    PubMed  Google Scholar 

  64. Leroy X, Gonzalez S, Zini L, Aubert S. Lipoid-cell variant of urothelial carcinoma: a clinicopathologic and immunohistochemical study of five cases. Am J Surg Pathol. 2007;31(5):770–3.

    PubMed  Google Scholar 

  65. Soylu A, Aydin NE, Yilmaz U, Kutlu R, Gunes A. Urothelial carcinoma featuring lipid cell and plasmacytoid morphology with poor prognostic outcome. Urology. 2005;65(4):797.

    PubMed  Google Scholar 

  66. Kramer MW, Abbas M, Pertschy S, Becker JU, Kreipe HH, Kuczyk MA, et al. Clear-cell variant urothelial carcinoma of the bladder: a case report and review of the literature. Rare Tumors. 2012;4(4):e48.

    PubMed Central  PubMed  Google Scholar 

  67. Rotellini M, Fondi C, Paglierani M, Stomaci N, Raspollini MR. Clear cell carcinoma of the bladder in a patient with a earlier clear cell renal cell carcinoma: a case report with morphologic, immunohistochemical, and cytogenetical analysis. Appl Immunohistochem Mol Morphol. 2010;18(4):396–9.

    PubMed  Google Scholar 

  68. Yamashita R, Yamaguchi R, Yuen K, Niwakawa M, Tobisu K. Urothelial carcinoma (clear cell variant) diagnosed with useful immunohistochemistry stain. Int J Urol. 2006;13(11):1448–50.

    PubMed  Google Scholar 

  69. Kotliar SN, Wood CG, Schaeffer AJ, Oyasu R. Transitional cell carcinoma exhibiting clear cell features. A differential diagnosis for clear cell adenocarcinoma of the urinary tract. Arch Pathol Lab Med. 1995;119(1):79–81.

    CAS  PubMed  Google Scholar 

  70. Braslis KG, Jones A, Murphy D. Clear-cell transitional cell carcinoma. Aust New Zeal J Surg. 1997;67(12):906–8.

    CAS  PubMed  Google Scholar 

  71. Amin MB, Ro JY, Lee KM, Ordonez NG, Dinney CP, Gulley ML, et al. Lymphoepithelioma-like carcinoma of the urinary bladder. Am J Surg Pathol. 1994;18(5):466–73.

    CAS  PubMed  Google Scholar 

  72. Holmang S, Borghede G, Johansson SL. Bladder carcinoma with lymphoepithelioma-like differentiation: a report of 9 cases. J Urol. 1998;159(3):779–82.

    CAS  PubMed  Google Scholar 

  73. Tamas EF, Nielsen ME, Schoenberg MP, Epstein JI. Lymphoepithelioma-like carcinoma of the urinary tract: a clinicopathological study of 30 pure and mixed cases. Mod Pathol. 2007;20(8):828–34.

    PubMed  Google Scholar 

  74. Zukerberg LR, Harris NL, Young RH. Carcinomas of the urinary bladder simulating malignant lymphoma. A report of five cases. Am J Surg Pathol. 1991;15(6):569–76.

    CAS  PubMed  Google Scholar 

  75. Lopez-Beltran A, Luque RJ, Vicioso L, Anglada F, Requena MJ, Quintero A, et al. Lymphoepithelioma-like carcinoma of the urinary bladder: a clinicopathologic study of 13 cases. Virchows Arch. 2001;438(6):552–7.

    CAS  PubMed  Google Scholar 

  76. Allende DS, Desai M, Hansel DE. Primary lymphoepithelioma-like carcinoma of the ureter. Ann Diagn Pathol. 2010;14(3):209–14.

    PubMed  Google Scholar 

  77. Gulley ML, Amin MB, Nicholls JM, Banks PM, Ayala AG, Srigley JR, et al. Epstein-Barr virus is detected in undifferentiated nasopharyngeal carcinoma but not in lymphoepithelioma-like carcinoma of the urinary bladder. Hum Pathol. 1995;26(11):1207–14.

    CAS  PubMed  Google Scholar 

  78. Izquierdo-Garcia FM, Garcia-Diez F, Fernandez I, Perez-Rosado A, Saez A, Suarez-Vilela D, et al. Lymphoepithelioma-like carcinoma of the bladder: three cases with clinicopathological and p53 protein expression study. Virchows Arch. 2004;444(5):420–5.

    PubMed  Google Scholar 

  79. Torenbeek R, Blomjous CE, de Bruin PC, Newling DW, Meijer CJ. Sarcomatoid carcinoma of the urinary bladder. Clinicopathologic analysis of 18 cases with immunohistochemical and electron microscopic findings. Am J Surg Pathol. 1994;18(3):241–9.

    CAS  PubMed  Google Scholar 

  80. Lopez-Beltran A, Pacelli A, Rothenberg HJ, Wollan PC, Zincke H, Blute ML, et al. Carcinosarcoma and sarcomatoid carcinoma of the bladder: clinicopathological study of 41 cases. J Urol. 1998;159(5):1497–503.

    CAS  PubMed  Google Scholar 

  81. Young RH. Carcinosarcoma of the urinary bladder. Cancer. 1987;59(7):1333–9.

    CAS  PubMed  Google Scholar 

  82. Hodges KB, Lopez-Beltran A, Emerson RE, Montironi R, Cheng L. Clinical utility of immunohistochemistry in the diagnoses of urinary bladder neoplasia. App Immunohistochem Mol Morphol. 2010;18(5):401–10.

    CAS  Google Scholar 

  83. Westfall DE, Folpe AL, Paner GP, Oliva E, Goldstein L, Alsabeh R, et al. Utility of a comprehensive immunohistochemical panel in the differential diagnosis of spindle cell lesions of the urinary bladder. Am J Surg Pathol. 2009;33(1):99–105.

    PubMed  Google Scholar 

  84. Wright JL, Black PC, Brown GA, Porter MP, Kamat AM, Dinney CP, et al. Differences in survival among patients with sarcomatoid carcinoma, carcinosarcoma and urothelial carcinoma of the bladder. J Urol. 2007;178(6):2302–6; discussion 7.

    PubMed  Google Scholar 

  85. Wang J, Wang FW, Lagrange CA, Hemstreet Iii GP, Kessinger A. Clinical features of sarcomatoid carcinoma (carcinosarcoma) of the urinary bladder: analysis of 221 cases. Sarcoma. 2010;2010:454792.

    PubMed Central  PubMed  Google Scholar 

  86. Shah VM, Newman J, Crocker J, Chapple CR, Collard MJ, O’Brien JM, et al. Ectopic beta-human chorionic gonadotropin production by bladder urothelial neoplasia. Arch Pathol Lab Med. 1986;110(2):107–11.

    CAS  PubMed  Google Scholar 

  87. Dirnhofer S, Koessler P, Ensinger C, Feichtinger H, Madersbacher S, Berger P. Production of trophoblastic hormones by transitional cell carcinoma of the bladder: association to tumor stage and grade. Hum Pathol. 1998;29(4):377–82.

    CAS  PubMed  Google Scholar 

  88. Rodenburg CJ, Nieuwenhuyzen Kruseman AC, de Maaker HA, Fleuren GJ, van Oosterom AT. Immunohistochemical localization and chromatographic characterization of human chorionic gonadotropin in a bladder carcinoma. Arch Pathol Lab Med. 1985;109(11):1046–8.

    CAS  PubMed  Google Scholar 

  89. Martin JE, Jenkins BJ, Zuk RJ, Oliver RT, Baithun SI. Human chorionic gonadotrophin expression and histological findings as predictors of response to radiotherapy in carcinoma of the bladder. Virchows Arch A Pathol Anat Histopathol. 1989;414(3):273–7.

    CAS  PubMed  Google Scholar 

  90. Campo E, Algaba F, Palacin A, Germa R, Sole-Balcells FJ, Cardesa A. Placental proteins in high-grade urothelial neoplasms. An immunohistochemical study of human chorionic gonadotropin, human placental lactogen, and pregnancy-specific beta-1-glycoprotein. Cancer. 1989;63(12):2497–504.

    CAS  PubMed  Google Scholar 

  91. Iles R. Beta-hCG expression by bladder cancers. Br J Cancer. 1992;65(2):305.

    PubMed Central  CAS  PubMed  Google Scholar 

  92. Iles RK, Chard T. Human chorionic gonadotropin expression by bladder cancers: biology and clinical potential. J Urol. 1991;145(3):453–8.

    CAS  PubMed  Google Scholar 

  93. Iles RK, Purkis PE, Whitehead PC, Oliver RT, Leigh I, Chard T. Expression of beta human chorionic gonadotrophin by non-trophoblastic non-endocrine ‘normal’ and malignant epithelial cells. Br J Cancer. 1990;61(5):663–6.

    PubMed Central  CAS  PubMed  Google Scholar 

  94. Regalado JJ. Mixed micropapillary and trophoblastic carcinoma of bladder: report of a first case with new immunohistochemical evidence of urothelial origin. Hum Pathol. 2004;35(3):382–4.

    PubMed  Google Scholar 

  95. Grammatico D, Grignon DJ, Eberwein P, Shepherd RR, Hearn SA, Walton JC. Transitional cell carcinoma of the renal pelvis with choriocarcinomatous differentiation. Immunohistochemical and immunoelectron microscopic assessment of human chorionic gonadotropin production by transitional cell carcinoma of the urinary bladder. Cancer. 1993;71(5):1835–41.

    CAS  PubMed  Google Scholar 

  96. Abratt RP, Temple-Camp CR, Pontin AR. Choriocarcinoma and transitional cell carcinoma of the bladder—a case report and review of the clinical evolution of disease in reported cases. Eur J Surg Oncol. 1989;15(2):149–53.

    CAS  PubMed  Google Scholar 

  97. Morton KD, Burnett RA. Choriocarcinoma arising in transitional cell carcinoma of bladder: a case report. Histopathology. 1988;12(3):325–8.

    CAS  PubMed  Google Scholar 

  98. Wurzel RS, Yamase HT, Nieh PT. Ectopic production of human chorionic gonadotropin by poorly differentiated transitional cell tumors of the urinary tract. J Urol. 1987;137(3):502–4.

    CAS  PubMed  Google Scholar 

  99. Minamino K, Adachi Y, Okamura A, Kushida T, Sugi M, Watanabe M, et al. Autopsy case of primary choriocarcinoma of the urinary bladder. Pathol Int. 2005;55(4):216–22.

    PubMed  Google Scholar 

  100. Sievert K, Weber EA, Herwig R, Schmid H, Roos S, Eickenberg HU. Pure primary choriocarcinoma of the urinary bladder with long-term survival. Urology. 2000;56(5):856.

    CAS  PubMed  Google Scholar 

  101. Cho JH, Yu E, Kim KH, Lee I. Primary choriocarcinoma of the urinary bladder—a case report. J Korean Med Sci. 1992;7(4):369–72.

    PubMed Central  CAS  PubMed  Google Scholar 

  102. Hanna NH, Ulbright TM, Einhorn LH. Primary choriocarcinoma of the bladder with the detection of isochromosome 12p. J Urol. 2002;167(4):1781.

    PubMed  Google Scholar 

  103. Butler SA, Ikram MS, Mathieu S, Iles RK. The increase in bladder carcinoma cell population induced by the free beta subunit of human chorionic gonadotrophin is a result of an anti-apoptosis effect and not cell proliferation. Br J Cancer. 2000;82(9):1553–6.

    PubMed Central  CAS  PubMed  Google Scholar 

  104. Jenkins BJ, Martin JE, Baithun SI, Zuk RJ, Oliver RT, Blandy JP. Prediction of response to radiotherapy in invasive bladder cancer. Br J Urol. 1990;65(4):345–8.

    CAS  PubMed  Google Scholar 

  105. Lopez-Beltran A, Blanca A, Montironi R, Cheng L, Regueiro JC. Pleomorphic giant cell carcinoma of the urinary bladder. Hum Pathol. 2009;40(10):1461–6.

    CAS  PubMed  Google Scholar 

  106. Lopez-Beltran A, Cheng L, Comperat E, Roupret M, Blanca A, Menendez CL, et al. Large cell undifferentiated carcinoma of the urinary bladder. Pathology. 2010;42(4):364–8.

    CAS  PubMed  Google Scholar 

  107. Cox RM, Schneider AG, Sangoi AR, Clingan WJ, Gokden N, McKenney JK. Invasive urothelial carcinoma with chordoid features: a report of 12 distinct cases characterized by prominent myxoid stroma and cordlike epithelial architecture. Am J Surg Pathol. 2009;33(8):1213–9.

    PubMed  Google Scholar 

  108. Gilg MM, Wimmer B, Ott A, Langner C. Urothelial carcinoma with abundant myxoid stroma: evidence for mucus production by cancer cells. Virchows Arch. 2012;461(1):99–101.

    PubMed  Google Scholar 

  109. Tavora F, Epstein JI. Urothelial carcinoma with abundant myxoid stroma. Hum Pathol. 2009;40(10):1391–8.

    CAS  PubMed  Google Scholar 

  110. Hameed O. Myxoid cystitis with “chordoid” lymphocytes: another mimic of invasive urothelial carcinoma. Am J Surg Pathol. 2010;34(7):1061–5.

    PubMed  Google Scholar 

  111. Kawano H, Tanaka S, Ishii A, Cui D, Eguchi S, Hashimoto O, et al. Osteoclast-rich undifferentiated carcinoma of the urinary bladder: an immunohistochemical study. Pathol Res Pract. 2011;207(11):722–7.

    PubMed  Google Scholar 

  112. Baydar D, Amin MB, Epstein JI. Osteoclast-rich undifferentiated carcinomas of the urinary tract. Modern Pathol. 2006;19(2):161–71.

    Google Scholar 

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Authors and Affiliations

  1. Department of Pathology, University of Chicago Medical Center, Chicago, IL, USA

    Asst. Prof. Gladell P. Paner MD

  2. Department of Pathology, University of California at San Diego, La Jolla, CA, USA

    Prof. Donna E. Hansel MD, PhD

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  1. Asst. Prof. Gladell P. Paner MD
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  2. Prof. Donna E. Hansel MD, PhD
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Correspondence to Gladell P. Paner MD .

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Editors and Affiliations

  1. Department of Pathology, The Cleveland Clinic, Cleveland, Ohio, USA

    Cristina Magi-Galluzzi

  2. Department of Pathology, The Cleveland Clinic, Cleveland, Ohio, USA

    Christopher G. Przybycin

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Paner, G., Hansel, D. (2015). Urothelial Carcinoma Variants: Morphology and Association with Outcomes. In: Magi-Galluzzi, C., Przybycin, C. (eds) Genitourinary Pathology. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2044-0_15

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