Primary mucinous adenocarcinoma of the urinary bladder: a case report and review of Literature

Introduction: Primary mucinous adenocarcinoma of urinary bladder is an extremely rare disease. Symptomatically this tumor usually presents during the 5th and 6th decades of life with hematuria. It needs to be distinguished from mucinous adenocarcinoma metastasizing to the bladder from other primary sites. We report this case in a young man whose disease progressed to an advanced stage with minimal, irritative lower urinary tract symptoms and needed an extensive resection to achieve locoregional control. Case Report: This 30 yr old male patient had been having irritative lower urinary tract symptoms for one year and had been under symptomatic treatment from traditional medicine practitioners. On evaluation he was diagnosed to have mucinous adenocarcinoma of bladder with extensive nodal metastases and a nonfunctioning right kidney secondary to uretero vesical junction obstruction caused by the tumor. He has been managed with radical cystectomy along with nephrectomy, ureterectomy and a super extended lymphnode dissection. Conclusion: Adenocarcinomas of the bladder can present surreptitiously with minimal symptoms and no significant signs. A high index of suspicion is to be maintained while evaluating lower urinary tract symptoms. There should be a low threshold for ultrasound evaluation to avoid late diagnosis and morbidity. Mucinous Adenocarcinoma has an aggressive behavior and responds poorly to radiotherapy and chemotherapy.