Breaking the Age Barrier: Mucinous Adenocarcinoma of the Bladder in a Young Man

Abstract

Adenocarcinoma is a rare form of malignancy, representing approximately 0.5% to 2% of all bladder cancers. Approximately 90% of patients exhibit haematuria at presentation. The condition primarily affects adults, peaking in incidence during the seventh decade of life, with a higher occurrence in males. Tumors can develop throughout the urinary tract, including the bladder, urethra, renal pelvis and ureter. Due to its rarity, the underlying causes are not well understood. It has been postulated that bladder adenocarcinoma may result from malignant transformation of intestinal metaplasia in the urothelial mucosa. In our study we have diagnosed, A 24 year old male patient from West Bengal, who presented with tumor sized 3.8x3.5x3.5cm in the dome of bladder was diagnosed with primary invasive adenocarcinoma of bladder – mucinous type. The diagnostic challenge of this case that we had to thoroughly evaluate to exclude the primary from other organs like colon or prostrate. Mucinous and signet-ring cell histological patterns are extremely rare, and they are often challenging to differentiate morphologically from metastatic colorectal adenocarcinoma. Careful correlation with clinical, radiological, biopsy, staging and immunohistochemistry plays a vital role in diagnosing such rare tumor. Stage is important prognostic factor. 5 year disease free survival rate is 40-50%. Treatment is radical cystectomy followed by adjuvant therapy with chemo or radiotherapy, after excluding gastrointestinal origin primary malignancy