Bladder cancer in cystoscopically normal-appearing mucosa: a case of mistaken identity?

BJU Int. 2010 Nov;106(10):1499-501. doi: 10.1111/j.1464-410X.2010.09332.x.

Abstract

Objective: To test the frequency of malignancy in normal-appearing urothelium in patients with high-risk bladder cancer, as biopsy of normal-appearing mucosa using standard white-light cystoscopy (WLC) reportedly shows carcinoma in situ (CIS) in some patients with bladder tumours.

Patients and methods: Cold-cup biopsies of normal-appearing mucosa were obtained by two experienced oncological urologists from 63 patients during transurethral resection of bladder cancers. Each biopsy labelled as 'normal' was interpreted by two expert uropathologists.

Results: Each of the biopsies in all 63 patients was interpreted by both urological pathologists as showing normal or benign histology, except that one showed focal CIS.

Conclusions: Bladder urothelium appearing normal to expert urological oncologists using standard WLC rarely shows CIS when biopsies are evaluated by experienced uropathologists.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy, Needle
  • Carcinoma in Situ / pathology*
  • Carcinoma in Situ / surgery
  • Cystoscopy*
  • Epidemiologic Methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mucous Membrane / pathology
  • Mucous Membrane / surgery
  • Urinary Bladder / pathology*
  • Urinary Bladder / surgery
  • Urinary Bladder Neoplasms / pathology*
  • Urinary Bladder Neoplasms / surgery