Transitional cell carcinoma cystoscopy and bladder biopsy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Suveenkrishna Pothuru, M.B,B.S. [2]

Overview

Cystoscopy may be helpful in the diagnosis of transitional cell carcinoma.

Cystoscopy and Biopsy

• If the initial TURBT identifies muscle invasive (T2) disease, definitive therapy is generally indicated.
• Cystectomy may also play a role in the management of patients with non-muscle invasive bladder cancer.

• Any of the following represents a strong indication to proceed to cystectomy:

• T1 tumors with lymphovascular invasion

• Variant histologies, including micropapillary transitional cell carcinoma, sarcoma, squamous cell carcinoma, or adenocarcinomas

• T1, grade 3 tumors that were incompletely resected

• Prostatic duct/acinar CIS

• Relative indications :

• Ta or T1 high-grade plus CIS; T1b tumors (ie, deep involvement of lamina propria)

• Persistent T1, grade 3 tumors identified on reresection

• Recurrent or persistent disease within 6 to 12 months of initiating treatment with BCG

• Large-volume Ta, low-grade disease
• Women with bladder neck and/or urethra CIS
• However, decisions regarding cystectomy should be individualized based on the surgical risks of the patient.

• Cystoscopy may be helpful in the diagnosis of transitional cell carcinoma.
• Cystoscopy may be performed to do biopsy
• Cystoscopy is the gold standard for surveillance in patients with a history of bladder cancer
• To view histopathologic characteristic features of all transitional cell carcinoma, click here