Korean J Obstet Gynecol.  2011 Sep;54(9):543-547. 10.5468/KJOG.2011.54.9.543.

A case of double primary cancers of uterine endometrium and bladder with unusual histology

• Kim SA
• Park DC

• KMID: 2274081
• DOI: http://doi.org/10.5468/KJOG.2011.54.9.543

Abstract

A case of a moderate differentiated endometrial carcinoma of the uterus with a synchronous poorly differentiated bladder cancer is reported. A review of the literature revealed that simultaneous presentation of primary endometrial and bladder neoplasm is rare and usually related to low-stage bladder lesions in contrast to our case with undifferentiated and the deep myometrial invasion of bladder lesion. A 79-year-old woman with endometrial cancer stage IB was performed of total abdominal hysterectomy with bilateral salpingo-oophorectomy, pelvic and para-aortic lymph nodes dissection and adjuvant concurrent cisplatin-radiation therapy. After treatment, she complained intermittent gross hematuria. She was performed the bladder mucosal biopsy and finally diagnoses with poorly differentiated carcinoma of bladder. She received transurethral resection of bladder tumor alone without total cystectomy or any other adjuvant treatment due to her refusal. Her condition is tolerable except intermittent hematuria and anemia.

Keyword

Double primary cancer; Endometrial neoplasms; Bladder cancer

MeSH Terms

Aged
Anemia
Biopsy
Cystectomy
Disulfiram
Endometrial Neoplasms
Endometrium
Female
Hematuria
Humans
Hysterectomy
Lymph Nodes
Urinary Bladder
Urinary Bladder Neoplasms
Uterus
Disulfiram

Figure

• 

  Fig. 1 (A) Pelvic magnetic resonance imaging. About 2.8×2.6×2.4 cm sized T2 intermediate signal intensity mass (arrow) within the endometrial cavity and thinning of myometrium, especially right side body and fundus. (B) Pelvic computed tomography. Irregular lobulated tumor (arrow) around right posterior inferior wall of the urinary bladder with suspicious adjacent perivascular retroperitoneal space infiltration along the right internal iliac vessels.

• 

  Fig. 2 In the uterus, typical endometrioid adenocarcinoma invading myometrium is noted (A). The lesion in the urinary bladder is morphologically different from that of the uterus, and composed of highly pleomorphic malignant cells without forming glandular structure (B). Immunohistologically, these tumor cells show positive reaction to cytokeratin (CK)-7 (C) and vimentin (D), but negative reaction to CK20 (E). So, for the lesion in the urinary bladder, poorly differentiated carcinoma or carcinosarcoma is suspected. Magnification, ×200.

• 

  Fig. 3 Cystoscopic finding of transurethral resection of bladder tumor. Arrow indicated protruding tumor mass.

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