Cases reported "Urinary Bladder Neoplasms"

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1/13. Cytogenetic monoclonality in multifocal uroepithelial carcinomas: evidence of intraluminal tumour seeding.

    Twenty-one multifocal urinary tract transitional cell carcinomas, mostly bladder tumours, from a total of six patients were processed for cytogenetic analysis after short-term culturing of the tumour cells. Karyotypically related, often identical, cytogenetically complex clones were found in all informative tumours from each case, including the recurrent tumours. Rearrangement of chromosome 9, leading to loss of material from the short and/or the long arm, was seen in all cases, indicating that this is an early, pathogenetically important event in transitional cell carcinogenesis. The presence of related clones with great karyotypic similarity in anatomically distinct tumours from the same bladder indicates that multifocal uroepithelial tumours have a monoclonal origin and arise via intraluminal seeding of viable cancer cells shed from the original tumour. Later lesions may develop also from cells shed from the so called second primary tumours. The relatively complex karyotypes seen in all lesions from most cases argue that the seeding of tumour cells is a late event that succeeds the acquisition by them of multiple secondary genetic abnormalities.
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ranking = 1
keywords = carcinogenesis
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2/13. Colorectal adenocarcinoma as a second malignant neoplasm following rhabdomyosarcoma of the urinary bladder: a case report.

    Following improvements in therapy for childhood malignancies, the striking increase in survival rate over the past 30 years has led to the increase risk of developing second malignant neoplasms (SMNs). We report a case of colorectal carcinoma as a SMN, following treatment for rhabdomyosarcoma. The patient was diagnosed with rhabdomyosarcoma of the urinary bladder at his age of three years, and developed adenocarcinoma in the colon 13 years later. Histologic examination of the surgical specimen revealed adenocarcinoma involving the rectosigmoid area with radiation colitis in its background. The tumor cells showed strong immunoreactivity for p53 protein, suggesting the role of irradiation and p53 mutation in carcinogenesis. This case emphasizes the need for dose observation in survivors of early childhood malignancies treated with radiation and multiagent chemotherapy.
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ranking = 1
keywords = carcinogenesis
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3/13. urinary bladder cancer following cyclophosphamide therapy for Hodgkin's disease.

    urinary bladder cancers following prolonged cyclophosphamide therapy are being increasingly reported. We report a case of transitional cell carcinoma of the urinary bladder occurring 12 years after pulse intravenous therapy with cyclophosphamide for Hodgkin's disease. The mechanism of bladder carcinogenesis and the possible role of the uroprotector mesna in preventing cyclophosphamide induced bladder cancer are discussed.
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ranking = 1
keywords = carcinogenesis
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4/13. Primary squamous cell carcinoma in unreconstructed exstrophic bladder.

    bladder exstrophy is associated with an increased incidence of primary adenocarcinoma of the bladder. We report a rare case of squamous cell carcinoma occurring in the unreconstructed, exstrophic bladder of a 53-year-old woman treated with radical cystectomy and radiochemotherapy. This case represents the oldest patient to present with squamous cell carcinoma of an unreconstructed exstrophic bladder. We discuss the potential mechanisms of carcinogenesis in this patient, noting how they may potentially differ from those in a patient with a reconstructed bladder.
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ranking = 1
keywords = carcinogenesis
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5/13. Identification of human papillomavirus antigen in a bladder tumor.

    Human papillomavirus (HPV) antigen was found in one of six noninfiltrating (grade II) carcinomas of the bladder. The antigen was located in the nuclei of the superficial cells. This virus-bearing tumor occurred in a patient with no known risk factors. The presence of HPV in low-grade urinary lesions seems to be frequent and may reflect the early stages of carcinogenesis; in fact, HPV infections may cause papillomas and carcinomas of the urothelial mucosae as well as the genital mucosae.
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ranking = 1
keywords = carcinogenesis
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6/13. gamma-glutamyltransferase, a common marker of human epithelial tumors?

    Having previously established gamma-glutamyltransferase (GGT) as a marker of experimental carcinogenesis in rat liver, we investigated whether human tumors differ from their tissue or origin by showing a higher activity or different localization of this enzyme histochemically. We found such differences in each of the human carcinomas we examined. The presence of GGT activity in carcinomas arising in organs normally containing little (tongue) or no GGT activity (larynx, urinary bladder, and esophagus) clearly distinguished cancerous from normal epithelium. In the breast, colon and prostate, GGT activity was normally present in a defined anatomical distribution bordering luminal surfaces. Carcinomas arising from these tissues showed a loss of the normal pattern of activity and contained cells with almost homogenous GGT activity in the cytoplasm. Such differences clearly distinguished carcinomatous from normal epithelium in these organs. The increased GGT activity observed in all nine carcinomas arising from seven different organs suggests that GGT may be a common marker of human epithelial tumors and staining for GGT may become a useful tool in the detection of human epithelial neoplasms.
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ranking = 1
keywords = carcinogenesis
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7/13. Does cyclophosphamide induce bladder cancer?

    An increasing incidence of bladder neoplasms temporally associated with chemotherapy, usually cyclophosphamide, is being reported. These secondary primary bladder malignancies are characteristically found in two groups of patients: those with lymphoproliferative or myeloproliferative tumors, and those with immunosuppression after organ transplantation. A case of adenocarcinoma of the bladder associated with malignant lymphoma is reported, and the known cases of second primary bladder malignancies after cyclophosphamide therapy as reported in the literature are reviewed. Studies relating to the enhanced occurrence of second primary cancers in lymphoproliferative disorders are presented. The recognized urologic toxicities of cyclophosphamide, including cytopathologic changes in animals and humans, are discussed. The observed association between immunosuppression and second primary malignancies is explored, as supported by studies on congenital immunodeficiency in humans, viral oncogenesis in experimental animals, and neoplasia after organ transplantation. Possible mechanisms of carcinogenesis associated with cyclophosphamide are reviewed, including suppression of humoral and cell-mediated immune defense mechanisms, direct carcinogenesis, or cocarcinogenesis. A plea is made for the orderly reporting and careful documentation of bladder tumors in patients receiving cyclophosphamide. It is suggested that prospective studies in these patients and in patients receiving cyclophosphamide for nonmalignant disorders would be of value in assessing the culpability of cyclophosphamide as a carcinogen.
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ranking = 3
keywords = carcinogenesis
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8/13. adenocarcinoma developing in an ileal conduit.

    We report a case of adenocarcinoma that developed in an ileal conduit 18 years after cystectomy for transitional cell carcinoma of the bladder. The only presenting sign was gross hematuria. Retrograde ileal loopography and endoscopy of the ileal loop were useful in the diagnosis. To our knowledge adenocarcinoma arising in an ileal conduit after a radical procedure for transitional cell carcinoma of the bladder has not been reported previously. The literature regarding malignancies that arise in portions of intestinal segments used as conduits is reviewed and carcinogenesis is discussed.
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ranking = 1
keywords = carcinogenesis
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9/13. Oncogenic human papillomaviruses are rarely associated with squamous cell carcinoma of the bladder: evaluation by differential polymerase chain reaction.

    While a strong association between oncogenic human papillomaviruses and squamous cell cancers of the genital tract (penis, urethra and cervix) is known to exist, there is substantial controversy regarding the association of human papillomaviruses and cancers of the bladder. Technical issues regarding assay technique and concern about potential contamination have marred interpretation of previous work. Moreover, because human papillomavirus has been associated predominantly with squamous cell cancers at other sites, any involvement of human papillomavirus and bladder epithelial carcinogenesis must address whether any association between human papillomavirus and squamous cell carcinoma of the bladder exists. Differential polymerase chain reaction and a rigorous protocol to avoid crossover contamination were used to analyze archival bladder carcinoma specimens (22 squamous cell carcinomas and 20 transitional cell carcinomas). Type specific primers for human papillomavirus types 16 and 18 were used as were general primers to detect types 6b, 11, 13, 16, 18, 31, 32, 33, 35, 45 and 51. Only 1 of 22 squamous cell carcinoma specimens (4.4%) was positive (human papillomavirus type 18)--a cadaveric renal transplant patient on chronic immunosuppression. Cervical specimens were human papillomavirus negative in this patient. No human papillomavirus deoxyribonucleic acid was detected in the 20 transitional cell carcinoma cohort. Our results confirm that these human papillomavirus types appear to have little association with invasive transitional cell cancers. Of greater significance, despite this (to our knowledge) first reported case of human papillomavirus type 18 detected in squamous cell carcinoma of the bladder (seen in an immunocompromised patient), we conclude that these oncogenic human papillomavirus types do not have a significant role in squamous cell carcinogenesis of the bladder.
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ranking = 2
keywords = carcinogenesis
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10/13. Do human papillomaviruses have a role in the pathogenesis of bladder carcinoma?

    PURPOSE: Since little is known of the associations between bladder carcinoma and human papillomaviruses (HPVs), data on the role of HPV in bladder carcinogenesis are controversial. We attempted to clarify whether HPVs are present in bladder carcinomas. MATERIALS AND methods: We examined 36 specimens of bladder carcinoma for HPV positivity by the polymerase chain reaction method. RESULTS: HPV-16 deoxyribonucleic acid was detected in 1 specimen (3%) of a transitional cell carcinoma from a 37-year-old woman who had concomitant squamous cell carcinoma of the uterine cervix with positive para-aortic lymph node metastasis. The cervical tumor, bladder tumor and para-aortic lymph node metastasis were all positive for the same type of HPV. CONCLUSIONS: On the basis of this low rate of HPV detection (3%), HPVs are not likely to have a prominent role in carcinogenesis of the bladder.
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ranking = 2
keywords = carcinogenesis
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