Urothelial bladder cancer

Case contributed by Dr Domenico Nicoletti

Presentation

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

Patient Data

Age: 66
Gender: Male
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.

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.

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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