PMC4314662_01
Axial contrast enhanced CT demonstrating bilateral ureteric dilation (hollow arrows) and a large enhancing intravesical mass (solid arrow).
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Computerised Tomography (CT) to assess his bladder and upper renal tracts. CT demonstrated a grossly thick walled bladder with a large enhancing intra-vesical mass, and bilateral hydroureteronephrosis ( Figure 1).
The bland appearance of the tumour at the bladder neck at his initial cystoscopy.
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At cystoscopy, there was a large papillary tumour involving the prostatic urethra, the trigone, and both lateral walls of the bladder. ( Figure 2) Neither ureteric orifice was identifiable.
Low power view (x4 objective lens) of Hematoxylin and Eosin (H and E) stained bladder resection specimen showing the large nests of the invasive component of urothelial carcinoma with abundant interspersed stromal tissue.
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Tumour histology this time demonstrated invasion into the muscularis propia by a large nested variant of UC ( Figure 3) with an adjacent superficial component of low grade papillary UC ( Figure 4).
Low power view (x4 objective lens) of Hematoxylin and Eosin (H and E) stained bladder resection specimen showing the superficial component of LNVUC.
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Tumour histology this time demonstrated invasion into the muscularis propia by a large nested variant of UC ( Figure 3) with an adjacent superficial component of low grade papillary UC ( Figure 4).
Low power view (x4 objective lens) of Hematoxylin and Eosin (H and E) stained bladder resection specimen showing focal invasion of tumour into peri-vesical fat.
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Tomography (PET) CT was negative for metastatic disease and a cysto-prostatectomy and formation of an ileal conduit was performed. The operative specimen histology again revealed the large nested variant of UC with focal invasion into peri-vesical fat ( Figure 5) and the prostatic stroma ( Figure 6).
Low power view (x4 objective lens) of Hematoxylin and Eosin (H and E) stained bladder resection specimen showing tumour nests invading prostatic stromal tissue.
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Tomography (PET) CT was negative for metastatic disease and a cysto-prostatectomy and formation of an ileal conduit was performed. The operative specimen histology again revealed the large nested variant of UC with focal invasion into peri-vesical fat ( Figure 5) and the prostatic stroma ( Figure 6).