Bladder, ureter & renal pelvis

Glandular neoplasms

Clear cell (adeno)carcinoma

Topic Completed: 1 December 2014

Minor changes: 26 October 2021

Copyright: 2003-2021,, Inc.

PubMed Search: clear cell adenocarcinoma bladder

Rugvedita Parakh, M.D.
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Cite this page: Parakh R Clear cell (adeno)carcinoma. website. Accessed December 6th, 2021.
Definition / general
  • Resembles clear cell carcinoma (Müllerian type) of female genital tract
  • Also called mesonephric or mesonephroid carcinoma / adenocarcinoma
  • Either arises from Müllerian elements in the bladder (endometriosis), represents a peculiar variant of vesical adenocarcinoma of non Müllerian 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
Microscopic (histologic) 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
Microscopic (histologic) description

Case of the Month #194

Various images





Positive stains
Negative stains
Differential diagnosis
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