Presentation
Raised PSAs, most recent 4.47. Moderately enlarged benign feeling prostate on PR examination. Are there any areas to target at biopsy?
Patient Data
Two papillary tumors on the posterior aspect of the bladder base measuring 2.5 cm. Further thickening of the left lateral bladder wall. One of the tumors covers the left ureteric orifice.
Diffuse PIRADS 2/3 changes in the peripheral zones. No focal significant PIRADS lesion.
No pelvic lymphadenopathy. Sigmoid diverticulosis.
No renal tract stones.
Both kidneys concentrate and excrete normally. Normal appearances of the collecting systems and ureters.
Two papillary tumors on the posterior aspect of the bladder base measuring 2.5 cm. Further thickening of the left lateral bladder wall. One of the tumors covers the left ureteric orifice. No hydronephrosis.
Simple cysts in the liver. The remainder of the solid organs are normal.
No adrenal or peritoneal nodules. No infradiaphragmatic lymphadenopathy.
Degenerative change in lumbar spine. No bone metastases.
Sigmoid diverticulosis.
Case Discussion
An unexpected finding of florid multifocal bladder TCC without any upper tract or distant metastatic disease.
The MR shows beautifully the papillary nature of some transitional carcinomas of the bladder.