Bladder
Urothelial carcinoma-invasive
Clear cell carcinoma

Author: Rugvedita Parakh, M.D. (see Authors page)

Revised: 15 August 2016, last major update December 2014

Copyright: (c) 2003-2016, PathologyOutlines.com, Inc.

PubMed Search: Clear cell carcinoma bladder
Definition / General
  • Resembles clear cell carcinoma (mullerian type) of female genital tract
Terminology
  • Also called mesonephric or mesonephroid carcinoma / adenocarcinoma
Etiology
  • Either arises from mullerian elements in the bladder (endometriosis), represents a peculiar variant of vesical adenocarcinoma of nonmullerian derivation, or represents a peculiar morphologic expression of urothelial carcinoma, with glandular differentiation often uncertain (Am J Surg Pathol 2002;190)
Clinical Features
  • Usually women, in bladder or urethra
  • Often high stage at diagnosis; stage is important prognostic factor
Case Reports
  • 35 year old woman with endometriosis (Mod Pathol 1993;6:225)
  • 70 year old woman with multiple recurrences of nephrogenic metaplasia of the urinary bladder and subsequent clear cell adenocarcinoma (Hum Pathol 2006;37:117)
Gross Description
  • Usually papillary, also sessile
  • If presents as polypoidal growth, frequent ulceration is seen
Micro Description
  • Often papillary or tubulocystic (Am J Surg Pathol 1985;9:816)
  • Flat or cuboidal neoplastic cells have abundant clear or eosinophilic cytoplasm with glycogen and frequent hobnailing
  • More pleomorphic cells and more mitotic figures than adenomatoid tumor; variable necrosis
  • Resembles urothelial carcinoma more than adenocarcinoma
  • The papillae sometimes have hyalinized cores
  • Myxoid stroma may be seen
Positive Stains
Negative Stains
Differential Diagnosis