[Uncommon bladder tumours]

Abstract

Bladder tumours are frequent with around 10,000 new cases each year in France. Less than 500 of these cases are not transitional cell carcinoma, the most frequent pathological aspect. The identification of these pathological patterns requires an initial biopsy through transurethral resection. Sarcomatoid, squamous and some adenocarcinomatous types are often pathological variants of the transitional pattern. These tumours are possibly secondary to alkylating drug metabolites or pelvic radiotherapy and they have often a poor prognostic outcome. This is also the case of spindle cell carcinoma, an endocrine variant of rare bladder cancers. The treatment is generally based on an aggressive approach combining chemotherapy and a radical cystectomy. Other tumours have a more locally invasive pattern, as have urachal adenocarcinomas, sarcomas. The treatment is based on aggressive surgical exeresis of the tumour and surrounding structures. The outcome may be more favourable. Primary non Hodgkin lymphomas are rare, secondary involvement more frequent. All histological subtypes could be encountered. The treatment is the same as this of lymphomas of other location and of the same histology. Attention must be drawn on a precise evaluation of the pathological pattern and of the disease extension.