Microcystic Variant of Urothelial Carcinoma: A Review and Update

Background: The microcystic variant of urothelial carcinoma is one of the new urothelial carcinoma types recognised by the World Health Organization (WHO) in 2004.

The aim of this study was to conduct a literature review on the microcystic form of urothelial carcinoma.

Materials and Methods: The presentation, diagnosis, treatment, and outcomes of microcystic urothelial carcinoma were recorded using various internet search engines.

Results: (Summary of the Literature Review and Update): Microcystic urothelial carcinoma is a rare form of urothelial carcinoma that was introduced to the World Health Organization’s classification scheme in 2004.

The following characteristics of the microcystic form of urothelial carcinoma can be seen under a microscope:
• The lumina tend to be empty but may contain granular eosinophilic waste, mucin, or necrotic cells.
• The cysts are variable in size and are either circular or oval, up to 2mm; they are lined by urothelium, which is either flattened cells or low columnar cells.
• Their microscopic pattern resembles cystitis cystica and cystitis glandularis, which should be called differential diagnoses.
• Branched spaces that are elongated and irregular are common.
• Neuroendocrine differentiation can occur on occasion.

Just two patients had survived out of around 17 cases of microcystic urothelial carcinoma that had previously been identified. From 2017 to 2020, three more patients were identified, two of whom had lived for two years in one case and six months in another, but the author was unable to obtain definitive confirmation of the third person’s outcome or how long he had survived.

The biological behaviour of the microcystic strain of urothelial carcinoma is unknown due to its rarity, although there is some evidence to indicate that it is a high-grade and high-stage tumour. There is still no consensus about the appropriate treatment choice for the tumour.

Conclusions: Microcystic urothelial carcinoma is a rare tumour, with only around 25 cases published in the literature to the author’s knowledge.

Given the small number of cases of microcystic urothelial carcinoma published in the literature, it would be difficult to be dogmatic about its prognosis at this time.

New cases of microcystic urothelial carcinoma should be recorded by urologists, pathologists, and oncologists all over the world in order to track the biological behaviour of this unusual tumour.

However, based on the few cases of microcystic urothelial carcinoma that have been identified, it appears that this tumour is a highly aggressive tumour in general.

Author (s) Details

Anthony Kodzo-Grey Venyo
Department of Urology, North Manchester General Hospital, Delaunays Road, Manchester, United Kingdom.

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