125 Transitional Cell Carcinoma

CASE 125


Clinical Presentation


A 59-year-old man presents with painless gross hematuria.




image

Fig. 125.1 Noncontrast CT image through the pelvis shows a polypoid lesion (arrow) arising from the left posterior wall of the bladder.


Radiologic Findings


Noncontrast computed tomography (CT) image through the pelvis shows a polypoid lesion arising from the left posterior wall of the bladder (Fig. 125.1).


Diagnosis


Transitional cell carcinoma of the bladder


Differential Diagnosis



  • Primary bladder cancer
  • Malignant mesenchymal tumors (leiomyosarcoma, rhabdomyosarcoma)
  • Benign mesenchymal tumors (leiomyoma, paraganglioma, papilloma)
  • Blood clot
  • Prostatic enlargement
  • Infection (tuberculosis, schistosomiasis)
  • Hematoma
  • Lymphoma
  • Metastatic disease

Discussion


Background


Bladder cancer is ranked as the fourth most common malignancy in the United States. Transitional cell carcinoma accounts for 90% of cases and has a propensity to be multicentric with synchronous and metachronous bladder and upper tract tumors. Multicentric bladder tumors occur in 30 to 40% of cases (Fig. 125.2). Upper tract tumors occur in 3 to 5% of bladder tumor cases and are seen most frequently when multiple bladder lesions are present.



image

Fig. 125.2 Contrast-enhanced CT image of the pelvis shows multiple enhancing lesions (arrows) arising from the lateral bladder wall.


Clinical Findings

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Dec 26, 2015 | Posted by in GASTROINTESTINAL IMAGING | Comments Off on 125 Transitional Cell Carcinoma

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