Journals on Medical Drug and Therapeutics - BJSTR Journal

Abstract

With respect to T1 high grade #bladder tumour, 69% to 80% recurrence and 33% to 48% progression have been reported after #transurethral resection of bladder tumour (TURB) alone [1,2]. Over half of recurrence after TURB for T1 bladder tumour occurred in the previous site that means incomplete TURB contributed to the recurrence [3]. Therefore, cystoscopy should be repeated every 3 months for 2 years in T1 tumour [4]. A 68-year old man complained of #asymptomatic hematuria for 2 weeks. He had no underlying medical disease. He had never smoked. About a 2cm sized single papillary mass with wide base was located on the left lateral wall of urinary bladder (Figure 1). He underwent TURB, and T1 high-grade without carcinoma in situ was proven pathologically. A repeat TURB showed negative pathology. The patient did not want radical cystectomy at that time. 6 cycles of #bacillus Calmette-Guérinintravesical instillation were done. There was no abnormal lesion in cystoscopy at 3 and 6 months after TURB. However, the round mass was detected in dynamic computed tomography (CT) 6 months after TURB (Figure 2). In the specimen from radical #cystectomy, the tumour was not seen on the mucosa but it had invaded into perivesical fat tissue (Figure 3). 6 cycles of adjuvant chemotherapy with #Gemcitabine and Cisplatin were applied immediately after radical cystectomy. The patient has been followed up for 3 years with semi-annually CT after radical cystectomy without evidence of recurrence. Because of any possibility of incomplete TURB for pathological T1 high grade bladder tumor, or pathologically underestimated T stage of T2 bladder tumor, any imaging study such as CT scan or #bladder ultrasonography should be considered for T1 high bladder tumor, although a guideline recommends imaging study yearly [5].

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Progression of T1 High Grade Bladder Tumour without A Gross Mucosal Lesion after Transurethral Bladder Tumour Resection by Dong Sup Lee in BJSTR