Introduction & Objectives:
Bladder tumours are known for many histological variants . Better understanding of variants of bladder cancer leads to greater knowledge of prognosis and treatment strategies specific to individual variants .The aim is to evaluate incidence, clinical presentation ,histopathology , treatment and prognosis of rare variants of bladder cancer.
Materials & methods:
A retrospective review of institutional database was performed to identify all new patients of bladder tumour who presented to our department between January 2012 and December 2016. . The patient underwent cytoscopy with biopsy /TURBT and histopathology was reported by senior pathologists. The patients were treated according to standard treatment protocols.The patients were evaluated for incidence, clinical presentation ,pathological stage , treatment and median survival .
Results & Observations:
520 patients were identified to have bladder tumour . 33( 6%) patients had rare variant of bladder tumour with adenocarcinoma 15(2.8%), squamous cell carcinoma 6(1.1%) , sarcomatoid variant 4(0.7%) , poorly deffrentiated carcinoma 4 (0.7 %) , carcinosarcoma 3(0.6%) and one of nested variant (0.2%) . The most common presentation was hematuria 25(76%) and irritative LUTS 12(33%) . 26(78%) of patients had muscle invasive disease on presentation . Majority of patients underwent radical cystectomy 29(88%) . The patients had median survival adenocarcinoma 16 months , squamous cell carcinoma 36 months , sarcomatoid variant 15 months , poorly differentiated carcinoma 30 months and carcinosarcoma 39 months .
Conclusions:
The rare bladder tumors clinically have presentation similar to transitional cell carcinoma . They present at an advanced stage with majority being muscle invasive at presentation . The variants have poor median survival with adenocarcinoma and sarcomatoid variant having median survival less than 18 months .
Message:
The rare variants of bladder cancer are aggressive tumours which present late and have poor survival . They should be diagnosed early and managed aggressively .
Refrences
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