PMC6763565_01
Abdominal MRI, in axial section, showing the lesion (indicated by the white arrow) restricted to the bladder mucosa, close to the right ureteral ostium.
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F1
The CT scan was unable to determine whether there was tumor extravesical extension, so the patient underwent an MRI with contrast that showed that tumor was restricted to the bladder mucosa (Figure 1).
Abdominal CT scan, in axial section, showing the lesion (indicated by the black arrow) in the right posterolateral bladder wall.
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F2
A new CT scan with contrast identified a 29 x 22 mm solitary lesion in the same topography (Figure 2).
(A) Papillary urothelial carcinoma with some degree of cytoarchitectural disorder with moderate atypia. HEx100. (B) Detail of an area of high-grade atypia. HEx400.
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F3
The histopathological exam was compatible with atypical papillary urothelial hyperplasia, but immunohistochemistry favored the diagnosis of low-grade papillary urothelial carcinoma, with high-grade component and without invasion to the subepithelial tissue and muscularis propria, with free margins (Figures 3A,B).