We report the case of a 41-year-old man with painless hematuria for 18 months, in which an endoscopic study was initially performed, which showed the presence of a flat-like lesion located towards the bladder dome.
The patient underwent surgery, performing transurethral resection of the bladder, in which the entire tumor was resected.
The result of the pathological anatomy of the resection, reports Adenocarcinoma of bladder remnant, mucus-secreting, with signet ring cells.
Because of the low incidence of ADC at the vesical level, extension studies are performed.
Upper and lower digestive endoscopy were performed, which were verified within normal limits.
Similarly, computed tomography scan of the bladder neck showed a lesion to the dome, without demonstrating other lesions or adenomegaly in the pelvic region.
Since it was a solitary lesion, its insertion into the bladder dome, it was decided to perform a partial cystectomy, taking into account the cell line verified in the lesion, as well as the umbilical wall located in the bladder.
Similarly, extended ganglionic bifurcation was performed from iliac to bilateral ilioobturator region.
1.
Histopathology
Transurethral resection of the bladder
Poorly differentiated, mucosecretory adenocarcinoma with signet ring cells.
Extensive detachment of the detrusor muscle.
Immunohistochemistry studies were not performed in this case.
Partial cystectomy
- Anterior dome and face resection.
Mucinous adenocarcinoma with signet ring cells.
The patient was ulcerated and had no perivesical fat.
Perivesical ganglion with foci of micrometastases.
Presence of urothelial dysplasia in surrounding tissue of glandular origin.
- Foci of high-grade intraepithelial neoplasia in the urothelium adjacent to the tumour.
- Urach.
Fibrous and adipose connective tissue and tumor-free vessels.
Bilateral ilioobturator ganglia.
Nonspecific reactive hyperplasia.
No evidence of metastases.
- Tumor-free resection margins.
