[779] Metastatic Tumors to the Urinary Bladder.

Jonathan Chow, Pamela D Unger, Guang-Qian Q Xiao. Mount Sinai School of Medicine, New York, NY

Background: Secondary neoplasms involving the bladder are uncommon. True metastatic tumors to the bladder (MTB) are even rarer. Our experience with MTB along with the clinicopathologic findings is presented.
Design: We define bladder metastases as secondary tumors within the muscularis or lamina propria of the bladder, with the exclusion of direct extension of tumors from adjoining organs. A total of 15 cases of MTB were found from our archives between 1995 and 2010. Pathologic and clinical findings were recorded.
Results: 11/15 cases occurred in female patients. 9/11 individuals presented with hematuria or obstructive urinary symptoms. 9 cases were diagnosed by transurethral resection of bladder tumor, 2 cases were obtained by biopsy, and 4 cases were discovered on autopsy. 10/11 patients had MTB in the region of the trigone, posterior wall, or bladder neck. The vast majority presented with cystoscopic findings of a mass, nodule, or thickened bladder wall, with overlying normal appearing bladder mucosa. 11/14 had concomitant metastases elsewhere. 8/11 patients died within 2 years of being diagnosed with bladder metastases. Breast (3/15) and gastric (3/15) malignancies were the most common MTB. MTB from ileal carcinoid tumor, ileal gastrointestinal stromal tumor, pancreatic gastrinoma, and renal collecting duct carcinoma have not been previously reported in the literature. Results are summarized in the table.

Clinicopathologic Features of MTB

Age	Sex	Primary Tumor	Bladder Location	Other Metastasis	Bladder Metastasis to Death (months)
53	F	B Ca, Pleomorphic Lobular	T,N	+	0.5
46	F	B Ca, Lobular	T,P	-	1
76	F	B Ca, Ductal	N,Periurethra	U	U
77	M	G Ca, Poorly Differentiated	T,P	+	6
33	M	G Ca, Signet Ring	T	+	1
83	F	G Ca, Signet Ring	T	+	1.5
51	F	Ileal Carcinoid	U	+	A
72	M	Ileal Gastrointestinal Stromal	U	+	U
94	F	Endocervical Adenocarcinoma	Left Ureteral Orifice	-	A
70	F	Fallopian Tube Ca, Serous Papillary	U	+	12
65	F	Ovarian Ca, Squamous	U	+	U
70	M	Gallbladder Adenocarcinoma	T,P	+	18
46	F	Pancreatic Gastrinoma	T,Right Dome	+	A
80	F	Renal Collecting Duct Ca	N	-	9
88	F	Lung Adenocarcinoma	P	+	U

B=Breast, G=Gastric, Ca=Carcinoma, T=Trigone, N=Neck, P=Posterior Wall, U=Unknown, A=Alive, + Present, - Absent


Conclusions: MTB usually occur late in the course of disease, with the majority of patients presenting with urinary symptoms. MTB have a greater affinity for specific regions of the bladder. For proper therapy, MTB must be distinguished from primary bladder neoplasms. Clinical correlation and morphologic recognition supplemented with immunohistochemistry is essential for reaching a correct diagnosis.
Category: Genitourinary (including renal tumors)

Tuesday, March 1, 2011 9:30 AM

Poster Session III # 201, Tuesday Morning