Author/Authors :
Kumari, itu National Institute of Pathology, Indian Council of Medical Research, New Delhi, India , Jha, Anupama National Institute of Pathology, Indian Council of Medical Research, New Delhi, India , Agrawal, Usha National Institute of Pathology, Indian Council of Medical Research, New Delhi, India , Vasudeva, Pawan Department of Urology - VMMC and Safdarjung Hospital, New Delhi, India
Abstract :
Micropapillary variant of urothelial carcinoma (UC) of the
bladder is an aggressive tumour, comprising 0.6-6% of all
UC. It generally presents with high-grade and stage, and has
been reported as having a worse prognosis when compared
to traditional UC. We report the case of a 58-year-old man
who presented with macroscopic haematuria. The patient
was diagnosed with high-grade urothelial carcinoma and
returned with recurrence after 16 months. Histopathology after
transurethral biopsy revealed a non-muscle invasive high-grade
bladder tumour at first presentation, whereas tumour recurrence
was reported after 1.5years. The histopathology at recurrence
revealed a high-grade, muscle invasive, micropapillary variant
of urothelial carcinoma with focal adenomatous morphology.
Immunohistochemical expression of CK7+/CK20+ in tumour
cells and negativity for PSA, AMACR, and CDX2 in paraffin
section helped in identifying the tumour as primary in the urinary
bladder. Radical cystectomy was performed and the patient has
no distant metastases on follow-up. The specific morphology
even within the high-grade urothelial cancer cases is important
to discern for proper treatment.
