Transitional cell carcinoma of the renal pelvis with choriocarcinomatous differentiation

Immunohistochemical and immunoelectron microscopic assessment of human chorionic gonadotropin production by transitional cell carcinoma of the urinary bladder

D. Grammatico, David Grignon, P. Eberwein, R. R. Shepherd, S. A. Hearn, J. C. Walton

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Abstract

Background. There have been 12 documented cases of choriocarcinoma arising in the urinary bladder, either alone or in combination with other epithelial tumors. It has been shown that some high-grade transitional cell carcinomas (TCC), without obvious syncytiotrophoblastic elements, can produce human chorionic gonadotropins (HCG). Methods. A case of choriocarcinoma, in association with high-grade TCC of the renal pelvis, was encountered in an 80-year-old man. For additional evaluation of HCG production by TCC, 25 consecutive cases of invasive high-grade TCC of the bladder were stained with an anti-HCG antibody. Immunogold staining also was performed in two of the cases studied. Results. Immunoperoxidase staining of the renal pelvis tumor showed focal positivity for HCG within the TCC and a more intense reaction as the tumor cells differentiated into choriocarcinoma elements. Seven of the 25 cases (28%) displayed varying degrees of reactivity within individual cells or groups of cells. In an additional case, typical syncytiotrophoblastic giant cells without cytotrophoblasts were seen in a high-grade TCC. Immunogold studies demonstrated positive labeling in the cytoplasm of carcinoma cells in a case of TCC without syncytiotrophoblasts and in the syncytiotrophoblastic giant cells in the one case in which these were present. Conclusions. The findings support a metaplastic origin of cases of choriocarcinoma arising primarily in the urothelial tract.

Original languageEnglish (US)
Pages (from-to)1835-1841
Number of pages7
JournalCancer
Volume71
Issue number5
StatePublished - 1993
Externally publishedYes

Fingerprint

Kidney Pelvis
Transitional Cell Carcinoma
Chorionic Gonadotropin
Urinary Bladder
Choriocarcinoma
Trophoblasts
Giant Cells
Staining and Labeling
Neoplasms
Cytoplasm
Carcinoma
Antibodies

Keywords

  • choriocarcinoma
  • human chorionic gonadotropin
  • kidney
  • transitional cell carcinoma

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

@article{824e8d69ef05458784bed5ade83b1866,
title = "Transitional cell carcinoma of the renal pelvis with choriocarcinomatous differentiation: Immunohistochemical and immunoelectron microscopic assessment of human chorionic gonadotropin production by transitional cell carcinoma of the urinary bladder",
abstract = "Background. There have been 12 documented cases of choriocarcinoma arising in the urinary bladder, either alone or in combination with other epithelial tumors. It has been shown that some high-grade transitional cell carcinomas (TCC), without obvious syncytiotrophoblastic elements, can produce human chorionic gonadotropins (HCG). Methods. A case of choriocarcinoma, in association with high-grade TCC of the renal pelvis, was encountered in an 80-year-old man. For additional evaluation of HCG production by TCC, 25 consecutive cases of invasive high-grade TCC of the bladder were stained with an anti-HCG antibody. Immunogold staining also was performed in two of the cases studied. Results. Immunoperoxidase staining of the renal pelvis tumor showed focal positivity for HCG within the TCC and a more intense reaction as the tumor cells differentiated into choriocarcinoma elements. Seven of the 25 cases (28{\%}) displayed varying degrees of reactivity within individual cells or groups of cells. In an additional case, typical syncytiotrophoblastic giant cells without cytotrophoblasts were seen in a high-grade TCC. Immunogold studies demonstrated positive labeling in the cytoplasm of carcinoma cells in a case of TCC without syncytiotrophoblasts and in the syncytiotrophoblastic giant cells in the one case in which these were present. Conclusions. The findings support a metaplastic origin of cases of choriocarcinoma arising primarily in the urothelial tract.",
keywords = "choriocarcinoma, human chorionic gonadotropin, kidney, transitional cell carcinoma",
author = "D. Grammatico and David Grignon and P. Eberwein and Shepherd, {R. R.} and Hearn, {S. A.} and Walton, {J. C.}",
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journal = "Cancer",
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TY - JOUR

T1 - Transitional cell carcinoma of the renal pelvis with choriocarcinomatous differentiation

T2 - Immunohistochemical and immunoelectron microscopic assessment of human chorionic gonadotropin production by transitional cell carcinoma of the urinary bladder

AU - Grammatico, D.

AU - Grignon, David

AU - Eberwein, P.

AU - Shepherd, R. R.

AU - Hearn, S. A.

AU - Walton, J. C.

PY - 1993

Y1 - 1993

N2 - Background. There have been 12 documented cases of choriocarcinoma arising in the urinary bladder, either alone or in combination with other epithelial tumors. It has been shown that some high-grade transitional cell carcinomas (TCC), without obvious syncytiotrophoblastic elements, can produce human chorionic gonadotropins (HCG). Methods. A case of choriocarcinoma, in association with high-grade TCC of the renal pelvis, was encountered in an 80-year-old man. For additional evaluation of HCG production by TCC, 25 consecutive cases of invasive high-grade TCC of the bladder were stained with an anti-HCG antibody. Immunogold staining also was performed in two of the cases studied. Results. Immunoperoxidase staining of the renal pelvis tumor showed focal positivity for HCG within the TCC and a more intense reaction as the tumor cells differentiated into choriocarcinoma elements. Seven of the 25 cases (28%) displayed varying degrees of reactivity within individual cells or groups of cells. In an additional case, typical syncytiotrophoblastic giant cells without cytotrophoblasts were seen in a high-grade TCC. Immunogold studies demonstrated positive labeling in the cytoplasm of carcinoma cells in a case of TCC without syncytiotrophoblasts and in the syncytiotrophoblastic giant cells in the one case in which these were present. Conclusions. The findings support a metaplastic origin of cases of choriocarcinoma arising primarily in the urothelial tract.

AB - Background. There have been 12 documented cases of choriocarcinoma arising in the urinary bladder, either alone or in combination with other epithelial tumors. It has been shown that some high-grade transitional cell carcinomas (TCC), without obvious syncytiotrophoblastic elements, can produce human chorionic gonadotropins (HCG). Methods. A case of choriocarcinoma, in association with high-grade TCC of the renal pelvis, was encountered in an 80-year-old man. For additional evaluation of HCG production by TCC, 25 consecutive cases of invasive high-grade TCC of the bladder were stained with an anti-HCG antibody. Immunogold staining also was performed in two of the cases studied. Results. Immunoperoxidase staining of the renal pelvis tumor showed focal positivity for HCG within the TCC and a more intense reaction as the tumor cells differentiated into choriocarcinoma elements. Seven of the 25 cases (28%) displayed varying degrees of reactivity within individual cells or groups of cells. In an additional case, typical syncytiotrophoblastic giant cells without cytotrophoblasts were seen in a high-grade TCC. Immunogold studies demonstrated positive labeling in the cytoplasm of carcinoma cells in a case of TCC without syncytiotrophoblasts and in the syncytiotrophoblastic giant cells in the one case in which these were present. Conclusions. The findings support a metaplastic origin of cases of choriocarcinoma arising primarily in the urothelial tract.

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