Primary Signet-ring-cell adenocarcinoma of the urinary bladder is an extremely rare variant that promotes considerable interest, 21 cases reported as of 1981.
Morphologically, this tumor is identical to signet-ring-cell carcinomas of the gastrointestinal tract, breast, lung and nasal cavity, and differentiation must be carried out with great care.
Characteristically, primary signet-ring-cell adenocarcinoma carries a poor prognosis with early penetration of the mucosa, submucosa, and muscularis.
This tumor is sessile, infiltrates early, extends locally to adjacent organs, and metastasized late. Many patients reported died of local extension with ureteral obstruction and uremia rather than wide spread metastasis.
We are reporting two cases of primary signet-ring-cell adenocarcinoma of the urinary bladder treated with radical cystectomy and transurethral resection with radiotherapy, which died of local extension with ureteral obstruction and uremia, with pathological findings and review of the literatures.
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