Adenocarcinoma (urinary bladder)
Citation, DOI, disclosures and article data
Citation:
Gaillard F, Ashraf A, Niknejad M, et al. Adenocarcinoma (urinary bladder). Reference article, Radiopaedia.org (Accessed on 27 Mar 2025) https://doi.org/10.53347/rID-9846
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rID:
9846
Article created:
Disclosures:
At the time the article was created Frank Gaillard had no recorded disclosures.
View Frank Gaillard's current disclosures
Last revised:
Disclosures:
At the time the article was last revised Ammar Ashraf had no financial relationships to ineligible companies to disclose.
View Ammar Ashraf's current disclosures
Revisions:
15 times, by
14 contributors -
see full revision history and disclosures
Systems:
Synonyms:
- Bladder adenocarcinoma
- Urachal carcinoma
- Adenocarcinoma of bladder
- Adenocarcinoma of the bladder
- Adenocarcinoma of the urinary bladder
Adenocarcinoma of the urinary bladder is rare and accounts for only ~1% of all bladder cancers (90% are transitional cell carcinomas).
On this page:
Pathology
Metaplasia of urinary bladder induced by chronic irritation or infection can lead to adenocarcinoma. Pathological types of adenocarcinoma of the urinary bladder are:
- mucinous adenocarcinoma
- signet-ring type
- papillary adenocarcinoma
- not otherwise specified (NOS)
Bladder adenocarcinoma may be subclassified as primary (two-thirds are non-urachal and one-third are urachal 2) or secondary (metastases).
Etiology
- persistent urachal remnant (most common)
- cystitis glandularis (itself secondary to bladder outlet obstruction, chronic infection and/or bladder calculi)
- schistosomiasis (bilharziasis), especially where endemic
- associated with bladder exstrophy
Radiographic features
CT
Non-urachal adenocarcinoma
- diffuse bladder wall thickening
- stranding of perivesical fat
- regional lymphadenopathy
- invasion of rectus muscles
Urachal adenocarcinoma
- characteristically in the midline at the dome of the bladder, or along the course of urachus (from the bladder to umbilicus)
- a midline, infraumbilical soft tissue mass with peripheral calcification is characteristically urachal adenocarcinoma unless proven otherwise (calcification in 70% of cases)
- usually large tumors (5-6 cm) with prominent extravesical component
- mixed solid-cystic appearance in most cases
MRI
Solid components of the tumor are isointense, while cystic mucinous component appears hyperintense on T2W images. Localizing a urachal carcinoma may be easier on the sagittal images.
Treatment and prognosis
Due to their extravesical location, urachal carcinomas present very late and thus carry a poor prognosis. Radical cystectomy is considered the treatment of choice. However, en bloc resection of the extravesical component, adjacent peritoneum and the abdominal wall is also needed.
Quiz questions
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References
- 1. Wong-you-cheong JJ, Woodward PJ, Manning MA et-al. From the Archives of the AFIP: neoplasms of the urinary bladder: radiologic-pathologic correlation. Radiographics. 26 (2): 553-80. doi:10.1148/rg.262055172 - Pubmed citation
- 2. Kapur P, Lotan Y, King E et-al. Primary adenocarcinoma of the urinary bladder: value of cell cycle biomarkers. Am. J. Clin. Pathol. 2011;135 (6): 822-30. doi:10.1309/AJCP76KUVOTBKQRY - Pubmed citation
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Articles:
- Hematospermia
- Cutaneous and subcutaneous metastases
- Bladder cancer
- Cystitis cystica
- Urachus
- Urachal cyst
- Urinary bladder wall or lumen calcification (differential)
- Leptomeningeal metastases
- Transitional cell carcinoma (urinary bladder)
- Tumours of the seminal vesicles
- Vesicourachal diverticulum
- Urogenital curriculum
- Urinary bladder wall thickening
Cases:
Multiple choice questions:
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