Primäres gemischtes adeno-neuroendokrines Karzinom (MANEC) der Harnblase – eine seltene Entität

Zusammenfassung

Ein 67-jähriger Mann stellte sich wegen eines zufällig diagnostizierten Blasentumors im Bereich der Hinterwand zur transurethralen Resektion vor. Bei der initialen histopathologischen Untersuchung wurde die Diagnose eines Adenokarzinoms mit partieller neuroendokriner Differenzierung gestellt. Mittels Röntgen-Thorax und Computertomografie des Abdomens konnte kein anderer Primarius identifiziert werden. Aufgrund der ungewöhnlichen Diagnose wurde der Fall zur konsiliarpathologischen Untersuchung an unser Pathologisches Institut geschickt. Hier wurde die Diagnose eines gemischten adeno-neuroendokrinen Karzinoms der Blase bestätigt. Gemischte adeno-neuroendokrine Karzinome (MANEC) sind seltene Tumore, die meist im Dickdarm auftreten. Nach unserem Wissen präsentieren wir hier den weltweit fünften Fall eines primären MANEC der Harnblase.

Abstract

A 67-year-old male patient underwent transurethral resection for a bladder tumour at the lower posterior wall found incidentally on imaging for an unrelated disease. The initial histomorphological examination suggested an adenocarcinoma with partial neuroendocrine differentiation. Imaging of the thorax and the abdomen, showed no evidence of another primary tumour. Due to the unusual diagnosis, the case was sent to our department of pathology for expert consultation, which confirmed the diagnosis of a primary mixed adeno-neuroendocrine carcinoma of the bladder (MANEC). Mixed adeno-neuroendocrine carcinomas are rare tumours that mostly occur in the colorectum. To our knowledge, this case is the fifth case report of a MANEC primarily arising in the urinary bladder.

Schlüsselwörter

Harnblase - gemischtes adeno-neuroendokrines Karzinom (MANEC) - Adenokarzinom - neuroendokrines Karzinom - transurethrale Resektion

Key words

bladder - mixed adeno-neuroendocrine carcinoma (MANEC) - adenocarcinoma - neuroendocrine carcinoma - transurethral resection

• Literatur

• 1 Cordier R. Les cellules argentaffines dans les tumeurs intestinales. Arch. Int. Med. Exp. 1924; 1: 5
• 2 Solcia E, Klöppel G, Sobin LH. Histological Typing of Endocrine Tumours (WHO International Histological Classification of Tumours). Berlin, Germany: Springer; 2000
• 3 Fred T, Bosman FC, Ralph H. et al. WHO Classification of Tomours of the Digestive System. WHO Press; 4. Edition 2010
• 4 Makino A, Serra S, Chetty R. Composite adenocarcinoma and large cell neuroendocrine carcinoma of the rectum. Virchows Archiv: an international journal of pathology 2006; 448: 644-647
• 5 Moch HHPA, Ulbright TM, Reuter VE. WHO Classification of Tumours of the Urinary System and Male Genital Organs. 4. Edition WHO Press; 2016
• 6 Shia J. et al. Is nonsmall cell type high-grade neuroendocrine carcinoma of the tubular gastrointestinal tract a distinct disease entity?. The American journal of surgical pathology 2008; 32: 719-731
• 7 Gurzu S. et al. Mixed adenoneuroendocrine carcinoma of gastrointestinal tract: report of two cases. World journal of gastroenterology 2015; 21: 1329-1333
• 8 Furukawa K. et al. Gastrointestinal: Gastric mixed adenoneuroendocrine carcinoma. Journal of gastroenterology and hepatology 2016; 31: 1236
• 9 Imaoka K. et al. A mixed adenoneuroendocrine carcinoma of the pancreas: a case report. Surgical case reports 2016; 2: 133
• 10 Lee L, Bajor-Dattilo EB, Das K. Metastatic mixed acinar-neuroendocrine carcinoma of the pancreas to the liver: a cytopathology case report with review of the literature. Diagnostic cytopathology 2013; 41: 164-170
• 11 Kamboj M. et al. Neuroendocrine Carcinoma of Gall Bladder: A Series of 19 Cases with Review of Literature. Journal of gastrointestinal cancer 2015; 46: 356-364
• 12 Nishimura C. et al. Pancreatic metastasis from mixed adenoneuroendocrine carcinoma of the uterine cervix: a case report. Case reports in oncology 2013; 6: 256-262
• 13 Abenoza P, Manivel C, Sibley RK. Adenocarcinoma with neuroendocrine differentiation of the urinary bladder. Clinicopathologic, immunohistochemical, and ultrastructural study. Archives of pathology & laboratory medicine 1986; 110: 1062-1066
• 14 La Rosa S, Marando A, Furlan D. et al. Colorectal poorly differentiated neuroendocrine carcinomas and mixed adenoneuroendocrine carcinomas: insights into the diagnostic immunophenotype, assessment of methylation profile, and search for prognostic markers. The American journal of surgical pathology 2012; 36: 601-611
• 15 Power DG, Asmis TR, Tang LH. et al. High-grade neuroendocrine carcinoma of the colon, long-term survival in advanced disease. Medical oncology 2011; 28 (Suppl. 01) 169-174
• 16 Maru DM. et al. Retrospective study of clinicopathologic features and prognosis of high-grade neuroendocrine carcinoma of the esophagus. The American journal of surgical pathology 2008; 32: 1404-1411
• 17 Rindi G. et al. Gastroenteropancreatic (neuro)endocrine neoplasms: the histology report. Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver 2011; 43 (Suppl. 04) S356-S360
• 18 Hom JD. et al. Adenocarcinoma with a neuroendocrine component arising in the urachus. A case report. Acta cytologica 1990; 34: 269-274
• 19 Chin NW, Marinescu AM, Fani K. Composite adenocarcinoma and carcinoid tumor of urinary bladder. Urology 1992; 40: 249-252
• 20 Satake TTS, Matsuyama M. Argyorphil cells in the urachal epithelium and urachal adenocarcinoma. Acta Pathol Jap 1984; 34: 1193-1197
• 21 Broede A. et al. Differential diagnosis of bladder versus colorectal adenocarcinoma: keratin 7 and GATA3 positivity in nuclear ss-catenin-negative glandular tumours defines adenocarcinoma of the bladder. Journal of clinical pathology 2016; 69: 307-312
• 22 La Rosa S, Marando A, Sessa F. et al. Mixed Adenoneuroendocrine Carcinomas (MANECs) of the Gastrointestinal Tract: An Update. Cancers 2012; 4: 11-30
• 23 Ploeg M. et al. Clinical epidemiology of nonurothelial bladder cancer: analysis of the Netherlands Cancer Registry. The Journal of urology 2010; 183: 915-920
• 24 Zaghloul MS. et al. Long-term results of primary adenocarcinoma of the urinary bladder: a report on 192 patients. Urologic oncology 2006; 24: 13-20
• 25 Engel RM, Wilkinson HA. Bladder exstrophy. The Journal of urology 1970; 104: 699-704
• 26 Harris A, Mc Leod CE. Colloid adenocarcinoma of the fundus of the bladder arising in the epithelium of the urachal canal: case report with summary of the literature. American journal of surgery 1953; 86: 739-742
• 27 Gopalan A. et al. Urachal carcinoma: a clinicopathologic analysis of 24 cases with outcome correlation. The American journal of surgical pathology 2009; 33: 659-668
• 28 Sheldon CA, Clayman RV, Gonzalez R. et al. Malignant urachal lesions. The Journal of urology 1984; 131: 1-8
• 29 Cheng L. et al. Molecular genetic evidence for a common clonal origin of urinary bladder small cell carcinoma and coexisting urothelial carcinoma. The American journal of pathology 2005; 166: 1533-1539
• 30 Cheng L. et al. Small cell carcinoma of the urinary bladder: a clinicopathologic analysis of 64 patients. Cancer 2004; 101: 957-962
• 31 Kouba EJ, Cheng L. Understanding the Genetic Landscape of Small Cell Carcinoma of the Urinary Bladder and Implications for Diagnosis, Prognosis, and Treatment: A Review. JAMA oncology 2017;
• 32 Abbas F, Civantos F, Benedetto P. et al. Small cell carcinoma of the bladder and prostate. Urology 1995; 46: 617-630
• 33 Choong NW, Quevedo JF, Kaur JS. Small cell carcinoma of the urinary bladder. The Mayo Clinic experience. Cancer 2005; 103: 1172-1178
• 34 Alfred Witjes J. et al. Updated 2016 EAU Guidelines on Muscle-invasive and Metastatic Bladder Cancer. European urology 2017; 71: 462-475
• 35 Agoff SN. et al. Thyroid transcription factor-1 is expressed in extrapulmonary small cell carcinomas but not in other extrapulmonary neuroendocrine tumors. Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc 2000; 13: 238-242
• 36 Jones TD. et al. Thyroid transcription factor 1 expression in small cell carcinoma of the urinary bladder: an immunohistochemical profile of 44 cases. Human pathology 2005; 36: 718-723
• 37 Lungenkarzinom-Prävention, Diagnostik, Therapie und Nachsorge (S3-Leitlinie). AWMF; 2010
• 38 Apostolidis LBF, Jaeger D, Winkler EC. Treatment outcomes of patients with mixed adenoneuroendocrine carcinoma (MANEC). Journal of Clinical Oncology 2015; (suppl; abstr) e15187
• 39 Früherkennung, Diagnose, Therapie und Nachsorge des Harnblasenkarzinoms (S3-Leitlinie). AWMF 1; 2016