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bladder cancer
A urologist reported visualizing "malignant bladder cancer" (transitional cell carcinoma) on cystoscopy. He performed a TURBT. Pathology results of the bladder tumor revealed a urothelial papilloma with cystitis cystica and glandularis, and focal intestinal metaplasia. The urologist recommended quarterly follow up cystoscopies for a minimum of 2 years. Based on what I believe is 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.
MEDICAL PROFESSIONAL
Urothelial papilloma is generally viewed as a benign bladder tumour with low risk of progression to bladder cancer.
Your pathology report sounds quite benign, but the presence of focal intestinal metaplasia tells us that the bladder lining is not 100% normal, and should certainly be followed up with cystoscopic surveillance. The frequency of cystoscopic surveillance depends on the urologist, although we generally recommend yearly follow-ups for at least 2-3 years.
The group from the Singapore General Hospital reported their experience of 52 patients with bladder papilloma - none developed bladder cancer after cystoscopic surveillance after a mean period of 5 years save one.
Sincerely,
Dr Ash Tewari, MD
1. Ho H, Chen YD., Tan PH, Wang M, Lau WK, Cheng C. Inverted papilloma of urinary bladder: is long-term cystoscopic surveillance needed? A single center's experience. Urology 2006; 68: 333-6.
Your pathology report sounds quite benign, but the presence of focal intestinal metaplasia tells us that the bladder lining is not 100% normal, and should certainly be followed up with cystoscopic surveillance. The frequency of cystoscopic surveillance depends on the urologist, although we generally recommend yearly follow-ups for at least 2-3 years.
The group from the Singapore General Hospital reported their experience of 52 patients with bladder papilloma - none developed bladder cancer after cystoscopic surveillance after a mean period of 5 years save one.
Sincerely,
Dr Ash Tewari, MD
1. Ho H, Chen YD., Tan PH, Wang M, Lau WK, Cheng C. Inverted papilloma of urinary bladder: is long-term cystoscopic surveillance needed? A single center's experience. Urology 2006; 68: 333-6.
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