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7 Cards in this Set
- Front
- Back
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What is the significance of micropapillary features on pathology?
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Micropapillary UC is an aggressive variant of UC. Intravesical Tx is generally ineffective. Patients with resectable dz should be offered radical cystectomy.
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What is mixed histology urothelial carcinoma (UC)?
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UC can mutate into different histology (e.g. squamous differentiation, glandular differentiation, etc.) yielding a histologic mixture. It is potentially more aggressive and may have a worse prognosis.
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What % of pts present with muscle invasive bladder CA?
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80%
15-20% progress from non-muscle invasive cancer after Tx with intravesical therapy |
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When does progression occur after locoregional therapy?
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Within first 2 yrs
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Small cell neuroendocrine cancer of the bladder
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Rare variant, may be mixed with TCC, IHC detection of synaptophysin and chromogranin
Tx: neoadjuvant chemo followed by radical cystectomy or XRT Assoc with paraneoplastic syndromes |
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Indications for initial cystectomy for T1 dz
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Up to 40% of pts initially dx as T1 who undergo cystectomy are pathologic T2
1. Size >3cm 2. Micropapillary histology 3. LV invasion 4. Recurrent HG T1 |
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4 pieces of critical info in staging bladder and urethra
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1. Upper tract obs or tumor?
2. T-stage on bimanual exam 3. Stage and depth of invasion with TURBT + directed bx 4. Status of the BN (female) and prostatic urethra (male) |
