Urothelial bladder cancer

Case contributed by Dr Domenico Nicoletti


Patient in the emergency room presenting with haematuria and a rising creatinine.

Patient Data

Age: 66
Gender: Male
Modality: CT

Multiple, arterial enhancing bladder lesions with signs of transmural infiltration and obstruction of bilateral ureteral meati, more so on the right. Associated bilateral hydroureter.

Modality: Ultrasound

Neoplastic vegetations covering the bladder inner surface, with complete obstruction of the right ureteral meatus and and partial obstruction of the left. Bilateral hydroureter.

Modality: Annotated image

Yellow circles highlight VUJ obstruction from bladder wall thickening. 

Case Discussion

Urothelial carcinoma constitutes 90% of bladder cancer. In rare cases, bladder cancer may be an adenocarcinoma or squamous cell carcinoma.

Since this is a urothelial disease, the tumour can also be localised to the pelvis and ureter. Bladder cancer usually appears as a vegetation within the bladder, less often a red and flat lesion, visible with cystoscopy.

Urothelial cancers can be superficial - limited to the mucosa and/or the lamina propria, while others show deeper infiltration into the muscle layer.

Urothelial carcinomas can demonstrate varying degrees of aggressiveness.

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Case Information

rID: 45339
Case created: 22nd May 2016
Last edited: 1st Sep 2016
Inclusion in quiz mode: Included

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