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Case Reports
. 2018 Aug 11;2018(8):omy050.
doi: 10.1093/omcr/omy050. eCollection 2018 Aug.

Advanced primary nonurachal adenocarcinoma of urinary bladder responding to modified FOLFOX6 and capecitabine: a case report

Frank S Fan  1 , Chung-Fan Yang  2
Affiliations
Case Reports

Advanced primary nonurachal adenocarcinoma of urinary bladder responding to modified FOLFOX6 and capecitabine: a case report

Frank S Fan et al. Oxf Med Case Reports. .

Abstract

Careful morphology and immunohistochemistry study can make an accurate differential diagnosis of primary adenocarcinoma of urinary bladder from metastatic lesions involving bladder, especially cancer arising in colon, but there is yet no consensus regarding the standard chemotherapy for advanced adenocarcinoma of urinary bladder among medical oncologists. Sustained response to modified FOLFOX6 (fluorouracil, oxaliplatin plus leucovorin) regimen and oral capecitabine for multiple metastases in a patient with primary nonurachal adenocarcinoma of urinary bladder is presented here as a strong support that the frontline chemotherapy for this infrequent malignant disease is just like what could be chosen for colorectal cancer.

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Figures

Figure 1:
Figure 1:
Enteric-type adenocarcinoma arising from urinary bladder (haematoxylin and eosin stain). (A) Cribriform and fused glandular pattern (×100). (B) Tumour cells similar to colon cancer with coagulative necrosis in the right upper field (×400).
Figure 2:
Figure 2:
Enteric-type adenocarcinoma invading into prostate gland (haematoxylin and eosin stain). (A) Enteric-type adenocarcinoma with dirty coagulative necrosis (×200). (B) Enteric-type adenocarcinoma similar to that seen in bladder specimen (×400).
Figure 3:
Figure 3:
Enteric-type adenocarcinoma arising from urinary bladder. Immunohistochemical staining: Positive for CK20 (A) and CDX2 (B). Negative for CK7 (C) and PSA (D).
Figure 4:
Figure 4:
Enteric-type adenocarcinoma invading into prostate gland. Immunohistochemical staining: Positive for CK20 (A) and CDX2 (B). Negative for CK7 (C) and PSA (D).
Figure 5:
Figure 5:
Enteric-type adenocarcinoma arising from urinary bladder. Immunohistochemical staining: Positive for β-catenin over cell membrane and cytoplasm (×400).
Figure 6:
Figure 6:
Change of serum tumour marker CA19-9 along the clinical course. Vertical axis: CA19-9 (U/ml). Horizontal axis: date in 2017. Dashed arrow boxes: periods of therapy with mFOLFOX6 and capecitabine, respectively.
Figure 7:
Figure 7:
CT scan, lung and liver windows. (A) and (B) 29 March 2017. (C) and (D) 22 November 2017. Much improvement of pulmonary and hepatic metastasis is demonstrated.
Figure 8:
Figure 8:
CT scan. (A) 15 March 2017. (B) 22 November 2017. Much improvement of right side adrenal metastasis is demonstrated.
See this image and copyright information in PMC

References

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