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ve·si·cal
ˈvesəkəl/adjective AnatomyMedicine
adjective: vesical of, relating to, or affecting the urinary bladder.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~open access:
Vesical clear cell adenocarcinoma arising from endometriosis: A mullerian tumor, indistinguishable from ovarian clear cell adenocarcinoma
Case Report.A 44-year-old para 0, with a history of urge urinary incontinence and recurrent urinary tract infections, presented with urinary frequency, incontinence, and hematuria. In 2008, she was diagnosed with urge incontinence and treated with tolterodine with improvement in symptoms. Multiple urinalyses at that time were positive for blood. The patient was lost to follow up until 2015, when she re-presented with recurrent symptoms. A urinalysis revealed many red blood cells and multiple urine cultures were negative.....The immunoprofile itself could not distinguish primary bladder clear cell adenocarcinoma from metastatic clear cell adenocarcinoma from the gynecologic tract.
- •Malignant transformation of extra-ovarian endometriosis is rare
- •Histology and immunohistochemistry support mullerian origin of this malignancy
- •Consideration can be given to extrapolating treatment from gynecologic literature
Abstract
Endometriosis,
the presence of endometrial glands and stroma at extra-uterine sites,
is common among reproductive age women, prevalence ranging 3–15% (Kim et al., 2014).
The etiology of endometriosis is unknown but proposed mechanisms
include retrograde menstruation, hematogenous or lymphatic
dissemination, and coelomic metaplasia. Endometriosis is most frequently
identified on the ovaries, rectovaginal septum, and broad and
uterosacral ligaments (Loizzi et al., 2015).
Endometriosis may also involve extra-pelvic organs including the small
and large intestine, abdominal scars, the urinary system, and the
lung/diaphragm. The bladder is the most common site of occurrence within
the urinary system, though it is involved in less than 1% of
extra-ovarian cases (Dadhania et al., 2015, Mann et al., 2012)....
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