Signet-ring cell adenocarcinoma of the bladder: case series between 1990-2009.

OBJECTIVES: To present a revision on the signet-ring cell bladder adenocarcinomas found in our department. METHODS/RESULTS: We reviewed all the transurethral resections of the bladder (TURB) performed between 1990 and 2009 finding 9 cases of primary signet ring cell adenocarcinomas (4 pure and 5 mixed). Eight were male and one female, with ages between 39 and 82 years. Definitive treatment was radical cystectomy with Bricker's urinary diversion in four patients, cysctectomy with Mainz's II diversion in one patient and palliative management with TURB in three cases and percutaneous nephrostomy in the remaining case. We used adyuvant chemotherapy in three cases. Only two patients were alive at the time of the study. Mean survival was 327 days for pure tumors and 586 for the mixed ones. CONCLUSIONS: Signet-ring cell primary adenocarcinoma of the bladder is an uncommon type of tumor, with worse prognosis than transitional cell cancer. It is important to discard other possible metastatic origins(like stomach, prostate, lung, or ovary) because the management will be different. Radical cystectomy is the treatment of choice, with adyuvant chemotherapy if possible. Five year survival is less than 11%

Adenocarcinoma vesical de células en anillo de sello: revisión de nuestros casos entre 1990-2009 / Signet-ring cell adenocarcinoma of the bladder: case review between 1990-2009

OBJETIVOS: Presentar una revisión de los adenocarcinomas primarios de vejiga de células en anillo de sello de nuestro servicio. MÉTODO/RESULTADO: Revisamos las RTU de vejiga realizadas entre 1990 y 2009 encontrando 9 casos de tumores primarios de vejiga de células en anillo de sello (4 puros y 5 mixtos).8 eran varones y 1 mujer, con edades comprendidas entre los 39 y los 82 años. Tratamiento definitivo consistió en cistectomía radical con derivación tipo Bricker en cuatro de los pacientes, cistectomía con derivación Mainz II en otro de ellos y paliativo en los cuatro restantes con RTU en tres casos y NPC paliativas en otro. Empleamos quimioterapia adyuvante en 3 casos. Sólo dos de los pacientes estaban vivos en el momento del estudio. La media de supervivencia fue de 327 días para los tumores puros y de 586 para los mixtos.CONCLUSIÓN: Los adenocarcinomas primarios de vejiga con células en anillo de sello son unos tumores poco frecuentes, con peor pronóstico que los de células transicionales. Es importante que descartemos los posibles orígenes metastásicos (de estómago, próstata, ovario, pulmón) ya que el manejo a seguir será distinto en función de la localización del tumor primario. El tratamiento de elección en los primarios de vejiga es la cistectomía radical, con quimioterapia adyuvante en los casos que sea posible. La supervivencia a 5 años es < al 11%(AU)

OBJECTIVES: To present a revision on the signet-ring cell bladder adenocarcinomas found in our department.METHODS/RESULTS: We reviewed all the transurethral resections of the bladder (TURB) performed between 1990 and 2009 finding 9 cases of primary signet ring cell adenocarcinomas ( 4 pure and 5 mixed). Eight were male and one female, with ages between 39 and 82 years. Definitive treatment was radical cystectomy with Bricker´s urinary diversion in four patients, cysctectomy with Mainz´s II diversion in one patient and palliative management with TURB in three cases and percutaneous nephrostomy in the remaining case. We used adyuvant chemotherapy in three cases. Only two patients were alive at the time of the study. Mean survival was 327 days for pure tumors and 586 for the mixed ones.CONCLUSIONS: Signet-ring cell primary adenocarcinoma of the bladder is an uncommon type of tumor, with worse prognosis than transitional cell cancer. It is important to discard other possible metastatic origins (like stomach, prostate, lung, or ovary) because the management will be different. Radical cystectomy is the treatment of choice, with adyuvant chemotherapy if possible. Five year survival is less than 11%(AU)