Primary signet-ring cell carcinoma of the urinary bladder: review of the literature and report of a case.

A case of primary signet-ring carcinoma of the urinary bladder treated with total cystectomy and clinically disease-free three years and nine months after surgery is described. The signet-ring cell carcinoma of the bladder is a rare neoplasm; among the five cases found in the literature, the neoplasms pursued a fulminant course, diffusely invaded the bladder wall without forming intraluminal growths, and could not be controlled by segmental resection, radiotherapy, and chemotherapy alone or in combinations. The pathogenesis of mucus-producing signet-ring cell carcinoma in the urinary bladder, an organ that normally contains no mucogenic elements, is discussed. The histologic evidence for the origin of this neoplasm from the totipotent urothelium is illustrated.