Transitional carcinoma of the bladder

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Smoker. Anemic with hematuria. Cause?

Patient Data

Age: 70 years
Gender: Male

 

Irregular 4.8cm cauliflower-like mass on the left posterolateral wall of the urinary bladder.  The mass covers the left ureteric orifice.  No extra-serosal invasion.

The upper tracts are normal in appearance.  No hydronephrosis.

Liver, spleen, pancreas, adrenals and bowel are unremarkable.

No ascites or abdomino-pelvic lymphadenopathy.

No destructive bony lesion. 

Case Discussion

An exceptionally large bladder tumor.   In many instances, in the investigation of hematuria, a CT is performed prior to cystoscopy (rightly or wrongly).  Rarely is such a pronounced tumor identified.

Assessment of the upper tracts is important to ensure no synchronous transitional cell carcinoma is present.

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