Lipoid-cell variant of urothelial carcinoma: report of a new case of the urinary bladder.

We report a new case of urothelial lipoid carcinoma of the urinary bladder, occurring in a 71 year-old woman. The tumor presented with metastatic involvement of the left axillary and supraclavicular lymph nodes. Clinical work up revealed a large infiltrating bladder tumor microscopically featuring poorly differentiated, pleomorphic cells with nuclear pleomorphism and frequent mitoses. Large, optically clear intracytoplasmic vacuoles imparting an adipocytic or signet-ring cell appearance could be noticed. Areas of conventional urothelial carcinoma were present as well. Due to the extensive invasion of the bladder coat, distant metastases as well as poor performance status radical cystectomy was not performed. The patient was treated with multimodality conservative therapy and is alive 9 months after the diagnosis.