Uncommon Tumors of Urinary Bladder

Introduction: Urinary bladder cancer is a prevailing cancer of the urinary system.Worldwide it is the ninth most common type of cancer. There are broadly twohistological types of bladder cancers: urothelial and non- urothelial. Urothelialcarcinoma is the predominant type with an incidence of 90-95%. Non-urothelialcancers are further subdivided into epithelial and nonepithelial. Epithelial cancersinclude squamous cell carcinoma, adenocarcinoma,andsmall cell tumors whereasnonepithelial cancers which are further more rare, include sarcomas, melanomas,lymphomas,and paragangliomas. Neurofibromas of thegenitourinary tract arise, fromnerves of thepelvic, vesical and prostatic plexuses. Cystitis glandularis is also a veryrare benign proliferative disease of urinary bladder mucosa and is usually amicroscopic diagnosis and rarely manifests as a large visible macroscopic mass ofurinary bladder.Materials and Methods: This is a prospective study conducted in a tertiary carehospital comprising six cases of unusual urinary bladder lesions. We studied the casesaccording to their age, sex, clinical presentation, location within the bladder,radiological findings, histopathological findings, immunohistochemical findings andtreatment provided.Results: This study comprisessix cases of unusual primary urinary bladder lesionswhich includes one case of squamous cell carcinoma, mucinous adenocarcinoma, clearcell carcinoma, paraganglioma, neurofibroma cystitis glandularis each. The patientsbelong to a wide age range between 3rd to 7th decade. There is male predominance.Hematuria is the common clinical presentation in all of them. Different locations withinthe bladder is involved in all these six cases. Histopathological examination followedby immunohistochemical staining of the formalin fixed paraffin embedded tissuesections confirmed their diagnosis.Conclusion:There are several histological variants of urinary bladder cancers, howeversquamous cell carcinoma, mucinous adenocarcinoma, and clear cell carcinoma areextremely rare. Extensive work-up, including immunohistochemical studies arerequired to rule out both the possibility of other sites of these primary tumors andpossibility of metastasis. Isolated urinary bladder neurofibromas are extremely rarewhich requires clinical follow up to monitor potential recurrence or progression.Paraganglioma are even more rare and incidentally detected. Cystitis glandularis is achronic disease and should be considered as a distinct clinical entity.