Diffuse cystitis glandularis. Associated with adenocarcinomatous change

Area of Science:

• Urology
• Oncology
• Pathology

Background:

• Cystitis glandularis is considered a premalignant lesion of the bladder.
• Malignant transformation of cystitis glandularis to adenocarcinoma is infrequently reported.
• Neurogenic bladder often requires urinary diversion, potentially leading to chronic bladder changes.

Observation:

• This study presents four cases of neurogenic bladder with varying urinary diversion durations.
• One case with a 25-year ureterocutaneostomy developed diffuse cystitis glandularis with multifocal adenocarcinoma.
• Another case with a 22-year suprapubic cystostomy showed diffuse gastrointestinal-type cystitis glandularis without malignancy.

Findings:

• The extent of cystitis glandularis correlated with the duration of urinary stasis.
• Inadequate drainage and constant infection in the ureterocutaneostomy case likely contributed to adenocarcinoma development.
• Prolonged irritation, infection, and toxic products may drive malignant degeneration in cystitis glandularis.

Implications:

• Diffuse cystitis glandularis, under conditions of chronic irritation and infection, may undergo malignant transformation.
• Urinary diversion management requires careful consideration to minimize risks associated with chronic bladder changes.
• Understanding the long-term sequelae of urinary stasis is crucial for bladder cancer prevention strategies.