What are the other Names for this Condition? (Also known as/Synonyms)

• Adenocarcinoma of Urinary Bladder
• Primary Adenocarcinoma of the Bladder
• Urinary Tract Adenocarcinoma

What is Adenocarcinoma of Urinary Tract? (Definition/Background Information)

• Adenocarcinoma of Urinary Tract is a rare and malignant tumor of the urothelial epithelium with glandular differentiation, typically affecting middle-aged and older adults (peak incidence between 60 and 70 years); about 65-75% of the cases are seen in males. Within the urinary tract, the malignancy may arise in the urinary bladder, renal pelvis, ureter, or urethra (very rarely). Generally, most cases arise in the urinary bladder
• Adenocarcinomas represent between 0.5-2% of all urinary tract cancers. The following histological subtypes of Adenocarcinoma of Urinary Tract are noted:
  • Adenocarcinoma NOS
  • Enteric adenocarcinoma (intestinal type)
  • Mucinous adenocarcinoma
  • Mixed adenocarcinoma
  • Signet-ring cell adenocarcinoma
  • Adenocarcinoma in situ - usually noted in the urinary tract mucosal surfaces
• Adenocarcinoma of Urinary Tract may be primary (rare) or secondary (more commonly seen). Primary adenocarcinomas arise from the urothelium (the urothelial cells that line the urothelial tract), while secondary tumors are those that metastasize/directly extend from other sites in the vicinity such as the colon, cervix, prostate, or lungs. This primary-secondary differentiation is important as it can dictate the treatment and overall outcomes
• Adenocarcinoma of Urinary Tract may develop from a pre-existing villous adenoma or progression of extensive cystitis glandularis. It is known to arise from bladder exstrophy (4-7% likelihood), parasitic infection schistosomiasis, surgical procedures to enlarge the urinary bladder (augmentation cystoplasty), and occasionally diverticulitis
• Other predisposing factors may include arsenic exposure, obstruction of the bladder, pelvic lipomatosis, and long-term bladder irritation. Several genetic anomalies have been described that may vary from one histological subtype to another. Some researchers believe that this tumor may arise from intestinal metaplasia of the urothelial lining undergoing a malignant transformation
• The signs and symptoms of Adenocarcinoma of Urinary Tract may include blood in urine (or hematuria, which is seen in 90% of the cases), and sometimes, mucus in urine (mucusuria), burning sensation on urination, and abdominal pain. Most of the tumors are solitary and nodular in nature. The presence of large tumor masses may cause obstructive symptoms within the urinary tract. Complications, such as tumor metastasis, to the lymph nodes and distant sites may take place; many tumors are diagnosed into the advanced stages
• The mainstay of treatment is a complete surgical excision of the tumor, such as radical cystectomy or nephroureterectomy, along-with a dissection of lymph nodes (for advanced stages). This may be followed up with treatment measures such as chemotherapy and radiation therapy. The prognosis of Urinary Tract Adenocarcinoma is generally improved if the tumor is diagnosed early and treated accordingly. The most important prognostic factor is the stage of the tumor. Other factors that influence outcomes include gender (females have generally better prognosis than males), location of the tumor, and the histological subtype