描述累及膀胱的妇科腺癌和潜在的诊断陷阱的文献有限。描述区分转移性（或扩展）妇科腺癌与具有腺体分化的尿路上皮癌的关键特征。回顾性回顾累及膀胱的妇科腺癌的手术病理学病例，来自 2 个不同机构，从外科病理学档案中检索，进行了操作。记录形态学特征以及可用的免疫组织化学结果。回顾了电子病历的临床和放射学信息。确定了 16 例累及膀胱的妇科腺癌（9 例子宫内膜子宫内膜样腺癌、4 例子宫内膜浆液性癌、2 例高级别输卵管卵巢浆液性癌和 1 例宫颈腺鳞癌）。所有纳入的病例均有粘膜受累，可能类似于原发性膀胱肿瘤，其中 4 例最初诊断为尿路癌。肿瘤表达角蛋白7（13个中的12个；92%）、PAX8（12个中的11个；92%）、雌激素受体（15个中的11个；73%）、p16（11个中的8个；73%）、黄体酮受体（14个中的8个） ；57%）、GATA3（12 个中的 5 个；42%）和 p63（11 个中的 3 个；27%）；所有肿瘤的角蛋白 20 均为阴性（12 个肿瘤中的 0 个）。支持苗勒氏管起源的特征包括既往妇科恶性肿瘤病史、非子宫内膜样肿瘤缺乏形态异质性、PAX8 和雌激素受体的免疫表型共表达且 GATA3 缺失。在部分病例中发现的潜在缺陷包括误导性放射学和膀胱镜检查结果、模仿肿瘤前体病变替代上覆尿路上皮粘膜、局灶性 GATA3 和/或 p63 阳性以及子宫内膜样组织学肿瘤中的鳞状分化区域。病史、某些形态学特征以及正确选择免疫组织化学染色是正确诊断累及膀胱的继发性妇科腺癌的关键。© 2023 美国病理学家学会。

There is limited literature describing gynecologic adenocarcinomas involving the urinary bladder, and potential diagnostic pitfalls.To describe key features distinguishing metastatic (or extension of) gynecologic adenocarcinomas from urothelial carcinomas with glandular differentiation.Retrospective review of surgical pathology cases of gynecologic adenocarcinomas involving the bladder, from 2 different institutions, retrieved from surgical pathology archives, was performed. Morphologic features were recorded, along with immunohistochemistry results when available. Electronic medical records were reviewed for clinical and radiographic information.Sixteen cases of gynecologic adenocarcinomas (9 endometrial endometrioid adenocarcinomas, 4 endometrial serous carcinomas, 2 high-grade tubo-ovarian serous carcinomas, and 1 cervical adenosquamous carcinoma) involving the bladder were identified. All included cases had mucosal involvement potentially mimicking primary bladder neoplasms, including 4 cases originally diagnosed as urinary carcinomas. Tumors expressed keratin 7 (12 of 13; 92%), PAX8 (11 of 12; 92%), estrogen receptor (11 of 15; 73%), p16 (8 of 11; 73%), progesterone receptor (8 of 14; 57%), GATA3 (5 of 12; 42%), and p63 (3 of 11; 27%); all tumors were negative for keratin 20 (0 of 12). Features supportive of Müllerian origin included prior history of gynecologic malignancy, lack of morphologic heterogeneity in nonendometrioid tumors, and immunophenotypic coexpression of PAX8 and estrogen receptor with absent GATA3. Potential pitfalls seen in a subset of cases included misleading radiologic and cystoscopic findings, replacement of the overlying urothelial mucosa by tumor mimicking precursor lesions, focal GATA3 and/or p63 positivity, and areas of squamous differentiation in tumors of endometrioid histology.A combination of clinical history, certain morphologic features, and proper selection of immunohistochemical stains is key for the correct diagnosis of secondary gynecologic adenocarcinomas involving the urinary bladder.© 2023 College of American Pathologists.