Urothelial carcinoma with prominent squamous differentiation in the setting of neurogenic bladder: Role of human papillomavirus infection Journal Article


Authors: Blochin, E. B.; Park, K. J.; Tickoo, S. K.; Reuter, V. E.; Al-Ahmadie, H.
Article Title: Urothelial carcinoma with prominent squamous differentiation in the setting of neurogenic bladder: Role of human papillomavirus infection
Abstract: Squamous cell carcinomas of the urinary bladder are rare in the Western world; the majority of cases are reported in countries endemic to Schistosoma parasitic infections. Unlike squamous tumors of the uterine cervix or oropharynx, the human papillomavirus (HPV) is not commonly associated with bladder squamous cell carcinomas. We report on two cases of HPV-positive urothelial carcinomas of the urinary bladder with extensive squamous differentiation showing the typical basaloid, poorly differentiated morphology of HPV-associated tumors. These occurred in patients with neurogenic bladders who had long-standing histories of self-catheterization with tumors that tested positive for HPV by in situ hybridization. A retrospective review of our institutional database revealed four additional patients with bladder tumors showing squamous differentiation arising in the setting of neurogenic bladder. Review of these cases showed the more common well-differentiated keratinizing appearance of squamous cell carcinomas of the bladder. These tumors showed only patchy positivity for p16 immunohistochemical stain (not the diffuse strong staining seen in HPV-positive tumors), and the one tested case was negative for HPV by in situ hybridization. HPV infection and neurogenic bladder have been independently associated with increased risk of developing carcinoma in the urinary bladder; however, this is the first report of squamous tumors arising in the setting of concurrent neurogenic bladder and HPV infection. The morphology of these tumors is similar to that of other high-risk HPV-associated squamous carcinomas with a basaloid, poorly differentiated appearance and little to no keratin formation. © 2012 USCAP, Inc. All rights reserved.
Keywords: squamous cell carcinoma; urothelial cancer; hpv; neurogenic bladder
Journal Title: Modern Pathology
Volume: 25
Issue: 11
ISSN: 0893-3952
Publisher: Nature Research  
Date Published: 2012-11-01
Start Page: 1534
End Page: 1542
Language: English
DOI: 10.1038/modpathol.2012.112
PROVIDER: scopus
PUBMED: 22766788
DOI/URL:
Notes: --- - "Export Date: 3 December 2012" - "CODEN: MODPE" - "Source: Scopus"
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  1. Satish K Tickoo
    483 Tickoo
  2. Kay Jung Park
    305 Park
  3. Victor Reuter
    1228 Reuter