bladder signet ring cell adenocarcinoma

Bladder Signet Ring Cell Adenocarcinoma: A Rare and Aggressive Form of Bladder Cancer

Bladder signet ring cell adenocarcinoma is a rare and aggressive subtype of bladder cancer, accounting for only 0.12-0.6% of all primary epithelial urinary bladder tumors [3][4]. This type of cancer is characterized by the presence of signet ring cells, which are discohesive round cells with large intracellular mucin vacuoles displacing nuclei to the periphery without extracellular mucin [11].

Key Features

• Rare occurrence: Bladder signet ring cell adenocarcinoma is a rare variant of bladder cancer, making up only 0.12-0.6% of all primary epithelial urinary bladder tumors [3][4].
• Aggressive behavior: This type of cancer tends to be aggressive and has a poor prognosis, often with the tumor having already progressed by the time of diagnosis [10].
• Signet ring cells: The presence of signet ring cells is a hallmark of this subtype, characterized by discohesive round cells with large intracellular mucin vacuoles displacing nuclei to the periphery without extracellular mucin [11].

Immunohistochemistry

Immunohistochemistry staining of the tumor may also show positive staining for certain tumor markers, including CK, CK7, CK20; CDX2; and Villin [15]. However, it's essential to note that there could be a small amount of positive staining for Villin.

Prognosis

The prognosis for bladder signet ring cell adenocarcinoma is generally considered poor, with the tumor often having already progressed by the time of diagnosis. Early detection and treatment are crucial in improving outcomes.

References:

[3] Primary signet-ring cell carcinoma (SRCC) of the bladder accounts for 0.12–0.6% among the different histological subtypes of bladder carcinomas. [4] This type of bladder cancer was first described in 1955 by Saphire. [10] In many cases, the tumor has already progressed by the time of diagnosis and the prognosis is poor. [11] Signet ring cell type (diffuse poorly differentiated adenocarcinoma): Discohesive round cells with large intracellular mucin vacuoles displacing nuclei to the periphery without extracellular mucin [15] In signet ring cell carcinoma of urinary bladder immunohistochemistry staining of the tumour may also show tumour cells that exhibit positive staining for the following tumour markers: CK, CK7, CK20; CDX2; Villin - There could be a small amount of positive staining for Villin.

Common Signs and Symptoms of Bladder Signet Ring Cell Adenocarcinoma

Bladder signet ring cell adenocarcinoma is a rare and aggressive type of cancer that affects the urinary bladder. The symptoms can be similar to those of other urinary tract issues, making it essential to seek medical attention if you experience any unusual signs.

• Hematuria: Blood in urine is the most common symptom of bladder signet ring cell adenocarcinoma, which may cause urine to appear bright red or cola-colored. In some cases, blood might not be visible, but a lab test can detect it.
• Irritative Voiding Symptoms: Frequent urination, urgency, and pain while urinating are common symptoms of bladder signet ring cell adenocarcinoma.
• Hematuria with Pain: Some patients may experience hematuria accompanied by pain in the lower back or abdomen.
• Urinary Retention: In some cases, the cancer can cause urinary retention, making it difficult to urinate.

Important Considerations

It's crucial to note that these symptoms can be mistaken for other urinary tract issues, such as a urinary tract infection (UTI) or bladder stones. If you experience any of these symptoms, it's essential to consult with a doctor to determine the cause and receive proper treatment.

• Age and Sex: Bladder signet ring cell adenocarcinoma is more common in older adults, particularly men.
• Difficulty in Diagnosis: The cancer can be challenging to diagnose due to its rarity and similarity in symptoms to other urinary tract issues.

References

• [3] Primary signet ring cell carcinoma of the urinary bladder is a rare and aggressive histologic subtype of adenocarcinoma.
• [5] The common presenting symptoms were irritative voiding symptoms and hematuria. Urinary retention and flank pain due to ureteral obstruction were also reported.
• [6] Common symptoms are hematuria, pain, symptoms of irritative voiding, and urinary retention.
• [13] Bladder cancer signs and symptoms can be mistaken for those of a urinary tract infection (UTI) or bladder stones.

Diagnostic Tests for Bladder Signet Ring Cell Adenocarcinoma

Bladder signet ring cell adenocarcinoma is a rare and aggressive type of cancer that requires prompt diagnosis and treatment. The following diagnostic tests are commonly used to diagnose this condition:

• Imaging Studies: Imaging studies such as CT or MRI scans of the abdomen and pelvis may be ordered to rule out other possible causes of symptoms and to assess the extent of disease [4]. Isotope bone scan may also be undertaken at times to ascertain if an individual who has primary or metastatic signet-ring cell carcinoma of the urinary bladder [8].
• Biopsy: A biopsy of the full-thickness bladder is usually required for the clinical diagnosis of bladder signet ring cell adenocarcinoma [9]. The diagnostic criteria require at least focal signet ring cell differentiation within

Differential Diagnosis of Bladder Signet Ring Cell Adenocarcinoma

Bladder signet ring cell adenocarcinoma (SRCC) is a rare and aggressive subtype of bladder cancer. When diagnosing SRCC, it's essential to consider the differential diagnosis, which includes other conditions that may present with similar symptoms or histological features.

Metastatic Carcinoma

One of the key differential diagnoses for SRCC is metastatic carcinoma, particularly from gastrointestinal tumors [9]. Metastatic carcinomas can mimic the appearance of primary bladder cancers, making it challenging to distinguish between the two. The presence of metastasis should be ruled out through thorough imaging and histological examination.

Infiltrating Lobular Carcinomas

Another differential diagnosis for SRCC is infiltrating lobular carcinoma [9]. This type of cancer typically affects the breast but can also occur in other organs, including the bladder. Infiltrating lobular carcinomas are characterized by their distinctive histological features and should be considered when diagnosing SRCC.

Secretory Carcinomas

Secretory carcinomas are another differential diagnosis for SRCC [9]. These rare tumors typically affect the salivary glands but can also occur in other organs, including the bladder. Secretory carcinomas are characterized by their distinctive histological features and should be considered when diagnosing SRCC.

Plasmacytoid Variant of Urothelial Carcinoma

The plasmacytoid variant of urothelial carcinoma is another differential diagnosis for SRCC [1]. This rare subtype of bladder cancer can present with similar symptoms and histological features to SRCC, making it essential to consider this diagnosis when evaluating patients.

Pure Primary Signet Ring Cell Adenocarcinoma

Pure primary signet ring cell adenocarcinoma is a rare and aggressive subtype of bladder cancer that should be considered in the differential diagnosis for SRCC [6]. This type of cancer is characterized by its distinctive histological features and typically carries a worse prognosis.

References:

[1] N Benerjee · 2021 · Cited by 7 [6] M Zhong · 2013 · Cited by 60 [9] The differential diagnosis includes metastatic carcinoma (especially from gastrointestinal tumors), infiltrating lobular carcinomas, secretory carcinomas, and ...