Popov Hristo, Stoyanov George S, Ghenev Peter
General and Clinical Pathology, Forensic Medicine and Deontology, Medical University of Varna, Varna, BGR.
Pathology, Complex Oncology Center, Shumen, BGR.
Cureus. 2023 Mar 22;15(3):e36554. doi: 10.7759/cureus.36554. eCollection 2023 Mar.
Adenocarcinomas of the urinary bladder are exceedingly rare and present in various morphological forms. Virtually all of these are identical to glandular malignant neoplasia native to topographically neighboring organs, where the incidence of adenocarcinoma is also much more common, such as the large intestine. Cases of glandular malignancies of the urinary bladder, therefore, require not only a detailed histopathological evaluation and interpretation but also a detailed clinical and radiological one. These should be performed with the goal of proving the origin of the tumor as one arising from the urinary bladder and not an entry originating from another organ and invading or producing metastasis to it. A controversial etiopathogenic link to urinary bladder adenocarcinoma is that of, which often coexists with the condition. Herein, we present a case report of non-muscle-invasive urinary bladder adenocarcinoma in a previously healthy male patient in his forties with a known history of . The patient presented with gross hematuria, and based on his known urological condition, a cystoscopy with biopsy was performed, showing submucosal proliferation of atypical glands. The detailed clinical and radiological evaluation showed no evidence of malignancy at other sites. As the malignancy was non-muscle-invasive, an intravesical dose of the Bacillus Calmette-Guérin vaccine was administered. The patient was followed up with cystoscopy, and a biopsy showed no evidence of residual malignancy, with persisting. A year following the diagnosis, the patient is still actively monitored, and no recurrence is noted.
膀胱腺癌极为罕见，呈现出多种形态学形式。实际上，所有这些都与地形上相邻器官的腺性恶性肿瘤相同，在这些相邻器官中，腺癌的发病率也更为常见，比如大肠。因此，膀胱腺性恶性肿瘤病例不仅需要详细的组织病理学评估和解读，还需要详细的临床和放射学评估。进行这些评估的目的应是证明肿瘤起源于膀胱，而非源自其他器官并侵入或转移至膀胱的病变。膀胱腺癌存在一个有争议的病因学关联，即 ，它常与该病症共存。在此，我们报告一例40多岁既往健康男性患者的非肌层浸润性膀胱腺癌病例，该患者有已知的 病史。患者出现肉眼血尿，基于其已知的泌尿系统状况，进行了膀胱镜检查及活检，结果显示非典型腺体的黏膜下增生。详细的临床和放射学评估未发现其他部位存在恶性肿瘤的证据。由于该恶性肿瘤为非肌层浸润性，给予了膀胱内剂量的卡介苗疫苗。对患者进行膀胱镜随访，活检显示无残留恶性肿瘤证据， 持续存在。诊断后一年，患者仍在接受积极监测，未发现复发情况。
