Bladder, ureter & renal pelvis

Glandular neoplasms

Clear cell (adeno)carcinoma



Last author update: 1 December 2014
Last staff update: 21 September 2022 (update in progress)

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PubMed Search: Clear cell adenocarcinoma bladder

Rugvedita Parakh, M.D.
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Cite this page: Parakh R Clear cell (adeno)carcinoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/bladderclearcell.html. Accessed December 10th, 2022.
Definition / general
  • Resembles clear cell carcinoma (Müllerian type) of female genital tract
Terminology
  • Also called mesonephric or mesonephroid carcinoma / adenocarcinoma
Etiology
  • 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

Contributed by @SueEPig on Twitter and Case #194
Clear cell (adeno)carcinoma Clear cell (adeno)carcinoma

Clear cell (adeno)carcinoma

Clear cell (adeno)carcinoma Clear cell (adeno)carcinoma

Clear cell (adeno)carcinoma


Various images


CK7

CD15

Ki67

p53

Positive stains
Negative stains
Differential diagnosis
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