[Unusual bladder tumors: primary epidermoid carcinoma, adenocarcinoma, and sarcoma. Clinical behavior. Our experience].
OBJECTIVE
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.


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 (> or = 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.
Servicio de Urología, Hospital de Sagunto, Valencia.
J A
JA
Queipo Zaragozá
F
F
Chicote Pérez
A
A
Borrell Palanca
J F
JF
Beltrán Meseguer
C
C
Alcalá-Santaella Casanova
B
B
Martínez García
F
F
Pastor Sempere
D000230:Adenocarcinoma / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D015653:Cystectomy; D005260:Female; D006801:Humans; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012509:Sarcoma / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy; D013030:Spain / Q000453:epidemiology; D016019:Survival Analysis; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy