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Urothelial carcinoma of the bladder with abundant myxoid stroma: A case report and literature review.
Tao, TT, Chen, J, Hu, Q, Huang, XJ, Fu, J, Lv, BD, Duan, Y
Medicine. 2020;(28):e21204
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Abstract
INTRODUCTION Abundant myxoid stroma rarely occurs in urothelial carcinomas (UCs). We report an 83-year-old woman with UC of the urinary bladder with abundant myxoid stroma. We summarized the clinicopathological features, immunophenotype, diagnosis, and differential diagnosis of this type of bladder cancer, in order to improve the understanding of surgeons and pathologists. PATIENT CONCERNS An 83-year-old female presented with hematuria and frequent micturition, without odynuria, hypogastralgia, or fever. DIAGNOSIS The computed tomography scan demonstrated extensive tumors in the anterior wall of the bladder and a soft tissue shadow anterior to the sacrum. Cystoscopy showed massive wide-based tumors located on the anterior and lateral walls of the bladder, with no tumor involving the bladder neck. Multiple punch biopsies were performed, the histologic evaluation of which revealed a poorly differentiated invasive UCs with myxoid stroma. INTERVENTIONS The patient underwent a laparoscopic radical cystectomy and cutaneous ureterostomy. OUTCOMES The patient discharged without any complications. Histologic evaluation revealed an invasive UC; the most prominent feature was an abundant myxoid stroma that covered approximately 80% of the lesion and the tumor cells were arranged in cords, small nests, or a sheet-like structure. Immunohistochemically, the tumor cells were positive for CK19, CK20, VEGF, EGFR, p63, 34βE12, MUC1, GATA3, uroplakin3, and TopII (rate = 15%), while the Ki-67 proliferation index was 10%. The myxoid stroma in the mesenchyme stained positively with AB-PAS and colloidal iron, and some tumor cells stained positive for colloidal iron. Considering the histologic, histochemical, and immunohistochemical findings, a diagnosis of UC with abundant myxoid stroma was made. After surgery, the regular follow-up was continued in clinic, and there was no recurrence for 2 years. CONCLUSION Morbidity associated with UC with abundant myxoid stroma is very low. The diagnosis mainly depends on histopathological and immunohistochemical findings.
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Signet-ring-cell carcinoma of stomach metastatic to the bladder: a case report with cytological and histological correlation and literature review.
Vigliar, E, Marino, G, Matano, E, Imbimbo, C, Rossella, de C, Insabato, L
International journal of surgical pathology. 2013;(1):72-5
Abstract
BACKGROUND Bladder involvement by a secondary tumor is fairly rare and an uncommon source of bladder metastasis is the stomach. CASE REPORT The authors report a case of a 38-year-old man with a bladder metastasis from a gastric signet-ring-cell (SRC) adenocarcinoma who presented with ematuria. The clinical history and the presence of SRCs in the voided urinary cytology and histologically in the suburothelial connective, with an overlying intact urothelium suggested a diagnosis of bladder metastasis from gastric carcinoma. CONCLUSION Bladder involvement by a secondary tumor is very rare, and a SRC carcinoma metastatic to the bladder, albeit extremely rare, should be considered in the differential diagnosis.
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Intravenously administered vitamin C as cancer therapy: three cases.
Padayatty, SJ, Riordan, HD, Hewitt, SM, Katz, A, Hoffer, LJ, Levine, M
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne. 2006;(7):937-42
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Abstract
Early clinical studies showed that high-dose vitamin C, given by intravenous and oral routes, may improve symptoms and prolong life in patients with terminal cancer. Double-blind placebo-controlled studies of oral vitamin C therapy showed no benefit. Recent evidence shows that oral administration of the maximum tolerated dose of vitamin C (18 g/d) produces peak plasma concentrations of only 220 micromol/L, whereas intravenous administration of the same dose produces plasma concentrations about 25-fold higher. Larger doses (50-100 g) given intravenously may result in plasma concentrations of about 14,000 micromol/L. At concentrations above 1000 micromol/L, vitamin C is toxic to some cancer cells but not to normal cells in vitro. We found 3 well-documented cases of advanced cancers, confirmed by histopathologic review, where patients had unexpectedly long survival times after receiving high-dose intravenous vitamin C therapy. We examined clinical details of each case in accordance with National Cancer Institute (NCI) Best Case Series guidelines. Tumour pathology was verified by pathologists at the NCI who were unaware of diagnosis or treatment. In light of recent clinical pharmacokinetic findings and in vitro evidence of anti-tumour mechanisms, these case reports indicate that the role of high-dose intravenous vitamin C therapy in cancer treatment should be reassessed.
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[A case of bladder tumor producing granulocyte-colony stimulation factor and parathyroid hormone-related protein].
Tsuchiya, F, Ikeda, I, Kanda, F, Fukuoka, H
Hinyokika kiyo. Acta urologica Japonica. 2001;(12):873-6
Abstract
A 68-year-old woman presented with urinary pain and frequency. Cystoscopy, intravenous pyelography and magnetic resonance imaging showed a huge bladder mass and hydronephrosis of the left kidney. Transurethral resection of bladder tumor (TUR-Bt) was done. Histopathological findings of TUR-biopsy was high grade transitional cell carcinoma. Post operatively, the laboratory examination showed marked leukocytosis with a maximum of 99,600/mm3 in the peripheral blood and a high level of granulocyte colony stimulating factor (G-CSF), 70 pg/ml in the serum (normal: less than 9.8 pg/ml). Serum calcium level increased gradually and parathyroid hormone-related protein (PTH-rP) revealed high, 8.4 pMol/l (normal: less than 0.6 pMol/l). The tumor cells were positive for G-CSF and PTH-rP immunohistochemical staining. She died of the disease 46 days after the operation. This is the third case of G-CSF and PTH-rP producing bladder tumor in the literature.