关键词: Bladder Carcinome urothélial Différenciation trophoblastique Trophoblastic differentiation Urothelial carcinoma Vessie

Mesh : Adult Biomarkers, Tumor / analysis Carcinoma, Transitional Cell / chemistry pathology Cell Differentiation Choriocarcinoma / diagnosis Chorionic Gonadotropin, beta Subunit, Human / analysis Diagnosis, Differential Female GATA3 Transcription Factor / analysis Humans Membrane Proteins / analysis Neoplasm Proteins / analysis Trophoblasts / chemistry pathology Urinary Bladder Neoplasms / chemistry pathology

来  源:   DOI:10.1016/j.annpat.2016.06.016

Abstract:
We report the case of a 43-year-old woman, who was admitted for intense pelvic pains. Biological investigations showed an increase of β-HCG level. The abdomino-pelvic computed tomography revealed a voluminous mass infiltrating the bladder. A transurethral resection was performed. The histopathological examination evidenced an invasion of the bladder by a massive carcinomatous proliferation composed of clear epithelial cells with in some places syncytiotrophoblastic cells and rarely cytotrophoblastic cells. Immunohistochemical analyses revealed a staining of GATA-3 by the two components, an expression of p63 by the clear cell urothelial component and the immunoreactivity of β-HCG by the trophoblastic component. Ki-67 labeling index was very high. The diagnosis of mixt urothelial carcinoma with clear cells and trophoblastic differentiation was proposed. This is a rare difficult histopathological diagnosis which should be known by pathologists. It is correlated to a poor clinical outcome with a high tendency to lymph node or visceral metastases.
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