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Signet-ring cell adenocarcinoma of the bladder: case series between 1990-2009.

OBJECTIVES
To present a revision on the signet-ring cell bladder adenocarcinomas found in our department.


METHODS/RESULTS
We reviewed all the transurethral resections of the bladder (TURB) performed between 1990 and 2009 finding 9 cases of primary signet ring cell adenocarcinomas (4 pure and 5 mixed). Eight were male and one female, with ages between 39 and 82 years. Definitive treatment was radical cystectomy with Bricker's urinary diversion in four patients, cysctectomy with Mainz's II diversion in one patient and palliative management with TURB in three cases and percutaneous nephrostomy in the remaining case. We used adyuvant chemotherapy in three cases. Only two patients were alive at the time of the study. Mean survival was 327 days for pure tumors and 586 for the mixed ones.


CONCLUSIONS
Signet-ring cell primary adenocarcinoma of the bladder is an uncommon type of tumor, with worse prognosis than transitional cell cancer. It is important to discard other possible metastatic origins(like stomach, prostate, lung, or ovary) because the management will be different. Radical cystectomy is the treatment of choice, with adyuvant chemotherapy if possible. Five year survival is less than 11%