Clear cell urothelial carcinoma of the urinary bladder: a case report and review of the literature

Journal of Medical Case Reports

Francisco G La Rosa²  Shandra Wilson¹  M Scott Lucia²  Willis Barrow²  Virginia M Knez² 

[1] Department of Urologic Oncology, School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO 80045, USA;Department of Pathology, School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO 80045, USA

关键词: Urothelial carcinoma;    Urinary bladder;    Cancer;    Clear cell;   

Others  :  1181077
DOI  :  10.1186/1752-1947-8-275

 received in 2014-05-01, accepted in 2014-07-03,  发布年份 2014

【 摘 要 】

Introduction

The occurrence of clear cell tumors in the bladder is not uncommon. Clear cell dysplasia is well-described and characterized by focal replacement of transitional mucosa by cells with abundant clear cytoplasm, nuclear enlargement, and a granular chromatin pattern. Clear cells can also be seen in clear cell adenocarcinoma, which is rare, comprising 0.5% to 2.0% of the reported bladder carcinomas. Other clear cell tumors found in the bladder to be considered in the differential diagnosis are tumors of Müllerian origin and metastatic lesions, such as renal cell carcinoma, clear cell sarcoma, and malignant melanoma. Clear cell urothelial carcinoma is exceedingly rare, with only nine clinical cases described in the literature.

Case presentation

We report the case of a 75-year-old Caucasian man who presented with intermittent hematuria, in whom a bladder tumor was identified. A final histopathology examination of a cystoprostatectomy specimen revealed a pT3b, G3 urothelial carcinoma of clear cell type (>90% clear cells) and a prostatic adenocarcinoma of Gleason grade 3+3 (score=6). The bladder tumor consisted of sheets of malignant cells with severe nuclear atypia and abundant clear cytoplasm; no glandular or tubular structures were identified. Tumor cells were periodic acid-Schiff positive and negative after diastase treatment; additional mucicarmine and oil red O stains were negative. Immunohistochemical stains showed the tumor cells positive for cytokeratin 7 (CK7), p63 (>80% nuclei), p53 (about 30% nuclei), vimentin, E-cadherin, cluster of differentiation (CD10), and Ki-67 (>70% nuclei). Stains for cell adhesion molecule 5.2 (CAM 5.2), CD117, cytokeratin 20 (CK20), human melanoma black 45 (HMB-45), paired box protein (PAX 8), placental alkaline phosphatase (PLAP), prostate specific antigen (PSA), renal cell carcinoma (RCC), cancer antigen 25 (CA25), leukocyte common antigen (LC), S-100 protein, and uroplakin III were all negative.

Conclusions

The tumor marker profile was consistent with clear cell type carcinoma of urothelial origin. Within the differential diagnoses, we ruled out other possible tumor types such as urothelial carcinoma with focal clear cell differentiation, clear cell adenocarcinoma, Müllerian tumors, and metastatic disease.

【 授权许可】

   
2014 Knez et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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