Cancer Res Treat.  2020 Oct;52(4):1283-1287. 10.4143/crt.2020.002.

Seminal Vesicle Involvement by Carcinoma In Situ of the Bladder: Clonal Analysis Using Next-Generation Sequencing to Elucidate the Mechanism of Tumor Spread

• Park HS
• Shin HB
• Lee MS
• Kim JH
• Kim SY
• Park J

• KMID: 2507953
• DOI: http://doi.org/10.4143/crt.2020.002

Abstract

We present a rare case of urothelial carcinoma in situ (CIS), which invades the prostate and seminal vesicle (SV). A 70-year-old man underwent transurethral resection of bladder (TURB), and the pathologic examination revealed multiple CIS. Although the patient received intravesical bacillus Calmette-Guerin (BCG) therapy following TURB, recurrence of CIS was confirmed in the bladder and left distal ureter at 3 months following BCG. Radical cystectomy was performed due to BCG-refractory CIS. Microscopically, CIS was found throughout the mucosa of the bladder, left ureter, prostatic duct, and both SVs. Next-generation sequencing revealed significant differences in tumor clonality between bladder and SV CIS cells. Among 101 (bladder CIS) and 95 (SV CIS) somatic mutations, only two were shared, and only one gene (ARHGAP23) was common exon coding region gene. In conclusion, multicentric genetic changes, in line with the field-cancerization effect, may result in SV involvement by CIS of the bladder.

Keyword

Urinary bladder neoplasms; Seminal vesicle involvement; Carcinoma-; High-throughput nucleotide sequencing; Clonality

Figure

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  Fig. 1. Computed tomography scan shows multiple enhancing lesion at bladder mucosa (yellow lines) (A) and segmental enhancement of the left distal ureter (red line) (B).

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  Fig. 2. Microscopic findings of radical cystectomy specimen. (A) Urothelial carcinoma in situ (CIS) is observed in the urinary bladder, in which mucosal epithelium is covered by the highly anaplastic tumor cells (H&E staining, ×400). (B) The prostatic acini and ducts are also involved by neoplastic urothelial cells (H&E staining, ×400). (C) The mucosa of the seminal vesicle shows pagetoid spread of the tumor cells (H&E staining, ×400). (D) In the urothelial CIS of the bladder, p53 was highly expressed on the nuclei of tumor cells (×400). (E) p53 was highly expressed in pagetoid spreading tumor cells of the seminal vesicle (×400). (F) Prostate-specific antigen was not expressed in the tumor cells in the ducts of prostate (×400).

Reference

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