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Differential diagnosis
by SL345, Jan 06, 2008 12:48PM
Upon a urologist visualizing transitional cell carcinoma during a cystoscopy, a TURBT was performed. Pathology results revealed urothelial papilloma with cystitis cystica and glandularis, and focal intestinal metaplasia. I have been told by the urologist that this is malignant bladder cancer. However, a pathologist who examined the slides told me that it is not cancer – never was and never will be – and that there is little or no risk of this problem recurring as a malignancy. The urologist recommended quarterly follow up cystoscopies for a minimum of 2 years. Based on what I believe are conflicting findings between the urologist and pathologist, I am considering the need for a second opinion. Your perspective would be very much appreciated. Thank you.
Member Comments (3)
by SL345, Jan 07, 2008 01:10PM
Is this kind of question inappropriate for this web site?
by Fernando Roque, MD, Jan 08, 2008 07:10AM
, Jan 08, 2008 07:10AMTo: SL345
Hi. I think the best thing to do in your case is to have the biopsy slides reviewed by a pathologist in a competent institution, preferably a specialty institution for cancer (e.g. MD Anderson). There is also the possibility that inadequate sampling of the lesion was done (that is, the mass contained only focal areas of cancer cells, and by chance, these areas were missed). If this is the case, then a re-biopsy has to be done.
by SL345, Jan 08, 2008 08:41PM
To: Fernando Roque, MD
Thank you. The urologist who performed the TURBT said that he thought "he got it all." Nevertheless, I have scheduled an appointment with a urologic oncologist at Memorial Sloan Kettering Cancer Center in NY. Your input is very much appreciated.
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