Plasmacytoid Carcinoma of the Urinary Bladder: An Invasive Urothelial Carcinoma Subtype with Important Staging and Follow-Up Implications.
Roberto Ricardo, Michael Nguyen, Neriman Gokden, Ankur Sangoi, Joseph Presti, Jr, Jesse McKenney. Stanford, Stanford, CA; University of Arkansas for Medical Sciences, Little Rock; El Camino Hospital, Mountain View, CA
Background: Plasmacytoid carcinoma of the urinary bladder is a urothelial carcinoma subtype/variant that has been emphasized in the literature for its morphologic overlap with both plasma cells and metastatic carcinomas from other anatomic sites. Our experience with plasmacytoid urothelial carcinomas suggests that they may have unusual patterns of disease spread that are not typical of urothelial carcinoma.
Design: We identified cases of plasmacytoid urothelial carcinoma diagnosed on radical cystectomy. All H&E stained glass slides were reviewed to confirm diagnoses. Patient age, sex, AJCC stage, and sites of metastatic spread/recurrence were recorded.
Results: 14 patients with plasmacytoid urothelial carcinoma diagnosed on radical cystectomy were identified. The patient ages ranged from 42 to 81 years (mean: 66.7; median: 69.5); 10 were male and 4 were female. 1 tumor was pT2, 9 were pT3, and 4 were pT4. 6 of 14 (43%) patients presented with lymph node metastases and 4 of 14 (29%) had unusual patterns of metastasis at the time of cystectomy and staging. These sites of metastatic spread included: 1 pre-rectal space; 1 ovary and vagina; 1 bowel serosa; and 1 omentum and bowel serosa. 3 patients are known to have had subsequent metastases involving: 1 pre-rectal space, 1 pleural fluid and small bowel serosa, and 1 bowel serosa.
Conclusions: In this study, 29% of patients with the plasmacytoid variant of urothelial carcinoma presented with atypical patterns of disease spread. The possibility of non-contiguous intra-abdominal spread that may involve serosal surfaces should be emphasized to ensure proper intraoperative staging and follow-up.
Category: Genitourinary (including renal tumors)
Tuesday, March 1, 2011 9:30 AM
Poster Session III # 193, Tuesday Morning