Metastatic Renal cell Carcinoma (Clear Cell Carcinoma) to the Urinary Bladder
Journal Title: Journal of Medical Science and Technology - Year 2015, Vol 4, Issue 1
Abstract
Metastatic renal cell carcinomas to the urinary bladder (MRCCTUB) are rarely encountered. Literature review on MRCCTUB was done by using various internet data bases to identify literature on MRCCTUB using the following search words: renal cell carcinoma metastatic to bladder; clear cell carcinoma metastatic to bladder. The review revealed that less than 100 cases of MRCCTUB have been reported in the English literature. MRCCTUBs may be synchronous or metachronous. MRCCTUBs may present with haematuria or lower urinary tract symptoms. Radiological imaging reveals a bladder mass. Cystoscopy reveals a non-papillary, solid, polypoid, pedunculated mass which may be yellowish. Metastatic renal cell carcinoma of the urinary bladder exhibits the following features: Delicate fibro-vascular stroma with abundant sinusoidal vessels, polygonal cells with abundant clear cytoplasm and nuclei. They may resemble urothelial carcinoma with clear cell features. MRCCTUBs on immunohistochemistry stain: (a) Positively with CAM 5.2, vimentin, Leu-M1 (CD15) (b) negatively with CK7, CK20, 34betaE12, CEA, S100, HMB45, chromogranin. The prognosis of MRCCTUs, have been generally poor and may depend upon whether they are solitary metastases or associated with metastases to other organs. MRCCTUs have on a number of occasions been confined to the bladder mucosa and these have been treated by trans-urethral resection. There is anecdotal information to suggest that intravesical BCG may help prevent local bladder recurrence. Systemic therapies have been used to treat disseminated disease with on the whole poor outcome. There is no consensus of opinion regarding the best treatment option. MRCCTUs are rare and there is no consensus opinion regarding their treatment in relation to other disseminated metastases. There is need for all cases of MRCCTUs to be entered in a multi-centric trial. Urologists and Oncologists should report cases of MRCCTUs they encounter.
Authors and Affiliations
Anthony Kodzo- Venyo
Keywords
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