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Umesh Jayarajah [1] and D. M. Hilary Fernando [1] and Kasun Bandara Herath [1] and M. V. Chandu de Silva [2] and S. A. S. Goonewardena [1]
Academic Editor: Mohamed A. Ghoneim
1, Department of Urology, National Hospital of Sri Lanka, Colombo, Sri Lanka, health.gov.lk
2, Department of Pathology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka, cmb.ac.lk
Received Jun 22, 2017; Revised Oct 30, 2017; Accepted Nov 21, 2017
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
1. Introduction
Bladder cancer is the 9th most common cancer in the world [1]. Histologically, about 90–95% of bladder cancers are of urothelial origin [2]. The incidence of adenocarcinoma of the bladder represents only 2% of all epithelial bladder tumours. Primary signet-ring cell carcinoma is a variant of adenocarcinoma which is extremely rare with estimated prevalence of 0.24% of primary bladder cancers [3, 4]. It was first described by Saphir in 1955, and less than 200 cases have been reported in the literature since then [5, 6]. It is associated with a poor prognosis and is generally found to be resistant to chemotherapy and radiotherapy [7]. We report a case of primary signet-ring cell carcinoma of the bladder treated with a partial cystectomy.
2. Case Presentation
A 71-year-old female presented with a history of intermittent episodes of painless haematuria with passage of clots for 2 months’ duration. She had a past history of type 2 diabetes mellitus, hypertension, and ischaemic heart disease. There were no other lower urinary tract symptoms and there was no family history of malignancies. The general and abdominal physical examinations were unremarkable. Haemoglobin was 8.6 g/dl on admission and required blood transfusions. Other basic biochemical parameters including serum creatinine were normal. The transabdominal ultrasonography showed a polypoidal vesical growth measuring 2.9 × 2.5 × 2.4 cm arising from the posterolateral wall of the bladder dome. The pre- and postvoid volumes were 180 ml and 44 ml, respectively. Both kidneys and upper urinary tracts appeared normal. Cystoscopy revealed an exophytic solid tumour measuring 1.5 × 2.0 cm arising from the anterior fundal wall covered with slough. A deep transurethral resection of bladder tumour was done.