Xiao Guang-Qian, Chow Jonathan, Unger Pamela D
Department of Pathology, Mount Sinai School of Medicine, New York, NY 10029, USA.
Int J Surg Pathol. 2012 Aug;20(4):342-8. doi: 10.1177/1066896911428736. Epub 2011 Nov 30.
Secondary neoplasms of the urinary bladder are uncommon, with metastatic tumors being an even rarer event. The authors studied the clinicopathology of 11 cases of metastatic tumors to bladder, which were collected from their archives between 1995 and 2010. The most common metastases in this series were breast. Some unusual metastases, including several not being previously reported, were also presented, namely, ileal carcinoid tumor, ileal gastrointestinal stromal tumor, ovarian squamous carcinoma, pancreatic gastrinoma, and renal collecting duct carcinoma. Vast majority of these patients (10/11, 91%) were female. Ninety percent of the patients presented with hematuria and/or obstructive urinary symptom as well as bladder lesions in the area of trigone, posterior wall, and/or bladder neck. Seven of the 11 patients had a known history of other metastases besides the bladder. Most of the patients (4/7, 57%) died within 1 year after diagnosis of bladder metastasis. Metastasis must be distinguished from a primary bladder neoplasm. Morphology and clinical correlation supplemented with immunohistochemical study is critical for the correct diagnosis.
膀胱继发性肿瘤并不常见,转移性肿瘤更是罕见。作者研究了1995年至2010年间从其档案中收集的11例膀胱转移性肿瘤的临床病理特征。该系列中最常见的转移部位是乳腺。还介绍了一些不常见的转移情况,包括几例此前未报道过的,即回肠类癌肿瘤、回肠胃肠道间质瘤、卵巢鳞状癌、胰腺胃泌素瘤和肾集合管癌。这些患者绝大多数(10/11,91%)为女性。90%的患者出现血尿和/或尿路梗阻症状以及膀胱三角区、后壁和/或膀胱颈部区域的膀胱病变。11例患者中有7例除膀胱转移外还有其他转移的已知病史。大多数患者(4/7,57%)在诊断膀胱转移后1年内死亡。转移瘤必须与原发性膀胱肿瘤相鉴别。形态学和临床相关性辅以免疫组化研究对于正确诊断至关重要。