title: Adenocarcinoma arising in urinary bladder endocervicosis.
abstract: Endocervicosis is a rare benign condition characterized by the presence of endocervical-type mucinous glands. Urinary bladder endocervicosis forms an elevated lesion in the posterior wall of the urinary bladder and is sometimes misdiagnosed as a malignant tumor clinically and pathologically. Herein we describe the first case of adenocarcinoma arising in urinary bladder endocervicosis. The patient, a 58-year-old woman, presented with asymptomatic hematuria. Cystoscopy revealed a nodular mass measuring 4 cm in diameter in the posterior wall, and total cystectomy was performed. Histology revealed that the elevated lesion of the bladder wall was composed of haphazard proliferation of cystic glands lined by benign endocervical-type epithelium. An adenocarcinoma arose at the center of this endocervicosis. Mucin histochemistry revealed the presence of sulfomucin in both the endocervicosis and adenocarcinoma components. Immunohistochemically, the endocervicosis was positive for cytokeratin (CK) 7, AE1/AE3, CAM5.2, HBME1, CA19-9, and estrogen receptor (ER), and negative for CK20, CDX2, progesterone receptor (PR), MUC5AC, and β-catenin. The adenocarcinoma showed similar immunohistochemical results, except for loss of ER expression and a slight increase in the ratio of Ki-67-positive cells. This case indicates that endocervicosis, known as a benign lesion, harbors the possibility of malignant transformation.
authors.affiliation: Department of Pathology, Tosei General Hospital, Seto, Japan.|Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Nakaguro
authors.affiliation: Department of Pathology, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Japan.
authors.forename: Toyonori
authors.initials: T
authors.lastname: Tsuzuki
authors.affiliation: Department of Pathology, Tosei General Hospital, Seto, Japan.|Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan.
authors.forename: Satoko
authors.initials: S
authors.lastname: Shimada
authors.affiliation: Department of Pathology, Tosei General Hospital, Seto, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Taki
authors.affiliation: Department of Pathology, Tosei General Hospital, Seto, Japan.
authors.forename: Mari
authors.initials: M
authors.lastname: Tsuchiyama
authors.affiliation: Department of Pathology, Tosei General Hospital, Seto, Japan.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Kitamura
authors.affiliation: Department of Pathology, Tosei General Hospital, Seto, Japan.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Suzuki
authors.affiliation: Department of Urology, Tosei General Hospital, Seto, Japan.
authors.forename: Yojiro
authors.initials: Y
authors.lastname: Nakano
authors.affiliation: Department of Pathology, Tosei General Hospital, Seto, Japan.
authors.forename: Kenzo
authors.initials: K
authors.lastname: Ono
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism / Q000473:pathology*; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002471:Cell Transformation, Neoplastic; D002584:Cervix Uteri / Q000378:metabolism / Q000473:pathology; D004715:Endometriosis / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D004848:Epithelium / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009077:Mucins / Q000378:metabolism*; D001743:Urinary Bladder / Q000378:metabolism / Q000473:pathology; D001745:Urinary Bladder Diseases / Q000378:metabolism / Q000473:pathology* / Q000601:surgery
chemical_list: D014408:Biomarkers, Tumor; D009077:Mucins; C012564:sulfomucin
keywords: Müllerianosis; adenocarcinoma; endocervicosis; urinary bladder