Urothelial neoplasm containing transitional cell component

Case contributed by Subash Thapa


Patient presented with hematuria. Serum investigation shows raised creatinine and urea level.

Patient Data

Age: 45 years
Gender: Male

There is a papillary and infiltrative intravesical mass involving the left postero-lateral wall of the urinary bladder which shows vascularity on color Doppler interrogation.

The mass is infiltrating into the left distal ureter causing left moderate hydroureteronephrosis. There is low ureteric jet on color Doppler study compatible with partial obstruction of the left distal ureter.

Echogenic debris within the urinary bladder.

The interface between the bladder and the prostate is intact.

3D surface rendering ultrasonography demonstrates an intravesical papillary projecting mass.

The patient underwent cystoscopy and biopsy, which revealed transitional cell carcinoma of urinary bladder.

Case Discussion

Patients with transitional cell containing urothelial cancers usually present with hematuria, although irritative symptoms from a secondary infection may be the initial complaint. When the tumor has obstructed one or both ureteral orifices, there may be aching loin pain, although the upper urinary tract obstruction is usually clinically silent because of its insidious onset.

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