Detecting Invisible Bladder Cancers With Blue Light Cystoscopy

A 90-year old man with no significant past medical history presented to urology clinic complaining of gross hematuria, urinary frequency, and dysuria. Previous urine cytology was atypical but 2 white-light cystoscopies failed to show any lesions. The patient was taken for intraoperative blue light cystoscopy, which revealed multiple lesions that were then resected. Pathology revealed high grade urothelial carcinoma with lamina propria invasion and the patient was managed successfully with Bacille Calmette Guerin therapy. This case highlights an important role for blue light cystoscopy in diagnosing patients with high suspicion for malignancy but negative white light cystoscopy.