What is a Cystadenocarcinoma?

Malignant tumors originated from the bladder mucosa (urinary epithelium). The tumors have a glandular structure and the histological type is adenocarcinoma. Including primary bladder adenocarcinoma and umbilical urinary adenocarcinoma. About 0.9% to 2% of the total number of bladder cancer patients. Cancer cell pathological types include adenocarcinoma, intestinal adenocarcinoma, signet ring cell carcinoma, mucinous adenocarcinoma, liver-like adenocarcinoma, clear cell carcinoma, and mixed types. Most bladder adenocarcinomas are poorly differentiated, aggressive, and have a poor prognosis. In some works, adenocarcinoma that has metastasized to the bladder from other organs is also classified as bladder adenocarcinoma, which is called bladder metastatic adenocarcinoma. However, according to the 2004 "Urological Pathology and Genetics of Urinary System and Male Reproductive Organ Tumors," urothelial tumor pathological classification, adenocarcinoma that has metastasized to the bladder is classified as a urothelial heterogeneous tumor, which is a secondary tumor of the bladder. Organ cancers directly invade the bladder in advanced stages, such as advanced rectal cancer, endometrial cancer, prostate cancer, and ovarian cancer, which invade the bladder. It can also be found in bladder metastatic adenocarcinoma caused by implantation of gastric cancer or hematogenous metastasis of breast cancer.

Basic Information

English name

adenocarcinoma of bladder

Visiting department

Oncology

Common locations

bladder

Common causes

The bladder mucosa has been chronically stimulated by chronic inflammation, bladder stones, long-term stimulation of the urinary catheter, and urinary tract obstruction.

Common symptoms

Gross hematuria, frequent urination, urgency, dysuria, lower abdominal discomfort, etc.

Causes of Bladder Adenocarcinoma

Primary bladder adenocarcinoma may be related to chronic inflammation of the bladder mucosa. The most common pathological type of bladder eversion is bladder adenocarcinoma. In addition, bladder stones, long-term stimulation of the urinary catheter, and urinary tract obstruction may be factors inducing bladder adenocarcinoma. Cystic cystitis is closely related to bladder adenocarcinoma. Glandular cystitis and leukoplakia are precancerous lesions. The pathogenesis of umbilical ureteral carcinoma is unclear. Most of the pathological types are mucinous adenocarcinoma and signet ring cell carcinoma. Because the inner layer of normal umbilical duct is covered with urothelial cells, it may be caused by metaplasia of urothelial cells.

Clinical manifestations of bladder adenocarcinoma

The most common symptom is gross hematuria. Followed by urinary tract irritation symptoms, including frequent urination, urgency, dysuria, lower abdominal discomfort, etc .; some patients have mucous urine, varying amounts of mucus, thick mucus can also block the urethra and urinary retention, which is bladder adenocarcinoma One of the characteristics.

Adenocarcinoma that originates from the umbilical urethra at the top of the bladder is occult and mostly asymptomatic, but some patients can touch the mass in the lower abdomen. Symptoms of infiltration and metastasis may occur in the later stages.

Bladder Adenocarcinoma Examination

Cystoscopy plus biopsy is the main method for diagnosing bladder cancer. Primary adenocarcinoma under cystoscopy is more common at the bottom of the bladder, the neck of the bladder, and the top of the bladder. It can also occur in any part of the bladder. Bladder adenocarcinomas can be papillary, polyp-like, or nodular, or they can be flat and ulcerated. The surface of tumor tissue is often accompanied by mucus, hemorrhage, and necrosis. In some cases, diffuse fibrosis can cause muscular hypertrophy, similar to leather-like. The diagnosis of bladder adenocarcinoma must rely on pathology and exclude metastatic adenocarcinoma. B-ultrasound, CT, and MRI examinations can show tumor size, invasion depth and extent, and presence or absence of pelvic lymphadenopathy to help clinical staging.

Bladder Adenocarcinoma Treatment

Because adenocarcinoma is not sensitive to radiotherapy or chemotherapy, surgical treatment is the most important treatment. Bladder adenocarcinoma is best treated with total cystectomy plus pelvic lymph node dissection. Transurethral bladder tumor resection is generally not used. Partial bladder resection can also be considered for isolated patients with localized bladder adenocarcinoma. For patients with umbilical carcinoma, an extended partial bladder resection is an option. For patients with metastasis, comprehensive treatment based on oncology should be given.