PMC10263023_01
Contrast-enhanced CT urography, coronal (A) and sagittal (L) view of the tumor (encircled with the red line). Left side (A) is showing the tumor extending into the urinary bladder. On the right side (L) the tumor extends into the urinary bladder, prostate and seminal vesicles.
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They showed a large, right-sided bladder tumor that infiltrated about half of the bladder and the seminal vesicles (Figure 1).
Poorly differentiated tumor with invasion of muscularis propria is present in TURBT specimen (asterisk). (A) Extensive cautery artifacts made histologic evaluation difficult (HE stain). (B) Strong positive nuclear reaction to GATA3 in bladder tumor, falsely indicating the tumor to be of urothelial origin.
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Histopathological examination of TURBT specimens with extensive cautery artifacts showed poorly differentiated carcinoma (Figure 2A). GATA3 was the only immunohistochemical marker used and because of its positivity (Figure 2B), the diagnosis of invasive high-grade urothelial carcinoma pT2 was made. 
Morphology of the tumor in the cystoprostatectomy specimen. (A) Tumor cells in luminal portions of the bladder are growing in small irregular nests (arrow) and as single cells. No urothelial carcinoma in situ was detected (asterisk) (HE stain). (B) Tumor cells in deeper portions of bladder are growing in solid nests and cords with presence of eosinophilic basement membrane-like material and focal microcystic architectural pattern, indicative of basal cell carcinoma (asterisk) (HE stain). (C) Periurethral portion of the prostate infiltrated with basal cell carcinoma growing in cords and as single cells with intratumoral hemorrhage (asterisk) (HE stain). (D) GATA3 stain of periurethral portion of prostate is showing positive tumor cells (asterisk) as well as basal cells of normal prostate glands and urothelium of prostatic urethra (arrows).
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The tumor cells in luminal portions of the bladder were growing in small irregular nests and as single cells (Figure 3A), but in deeper portions of the bladder wall, the tumor cells were growing in solid nests and cords accompanied by eosinophilic basement membrane-like material. In other areas, the microcystic architectural pattern was also present (Figure 3B). On thorough histopathological examination, it was evident that the tumor was originating in the transition zone of the prostate (Figure 3C), spreading to the bladder neck and occupying almost the whole bladder, more on the right side as seen on the CT scan. No urothelial carcinoma in situ was identified (Figure 3A).