Abstract

QUEIPO ZARAGOZA, J.A. et al. Unusual tumours of the bladder: primary epidermoid carcinoma, adenocarcinoma and sarcoma. Clinical behaviour. Our experience. Actas Urol Esp [online]. 2003, vol.27, n.2, pp.123-131. ISSN 0210-4806.

INTRODUCTION AND OBJECTIVES: Non-transitional cell tumours of the bladder are both a diagnostic challenge for the pathologist and a therapeutic challenge for the urologist, because although uncommon (less than 5% of all malignancies of the bladder) they show different biological behaviours each requiring a unique approach. The most significant pathoanatomical types are: primary epidermoid carcinoma, primary adenocarcinoma and primary sarcoma. This paper presents an analysis of our experience in these types of tumours. MATERIAL AND METHODS: A retrospective study of unusual cases of cancer of the bladder seen in our hospital between 1988-2001. Their biological behaviour and the therapies applied are analysed. The extravesical origin of the tumour was ruled out in all cases. RESULTS: We found 21 cases of the following pathoanatomical varieties: 13 epidermoid carcinomas, 7 adenocarcinomas (3 urachal) and 1 sarcoma. Mean age was very different between epidermoid carcinomas (69.2 ± 9.1 years) and adenocarcinomas (50.3 ± 8.1). Tumour behaviour was very aggressive in all three histological varieties. At the time of diagnosis 19 patients had locally advanced stages (≥T2). Although elective therapy was cystectomy, this was only feasible in 10 cases. Systemic chemotherapy (most frequently M-VAC) and/or local radiotherapy was used in 7 cases. 14 patients have died after a mean survival of 15.7 ± 11.6 months. CONCLUSIONS: Late diagnosis of these tumours and their aggressive biological behaviour involve a gloomy prognosis. Only early diagnosis and radical therapy could improve the prognosis.

Keywords : Tumour of the bladder; Epidermoid carcinoma; Adenocarcinoma; Sarcoma.

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