Bladder cancer in cystoscopically normal-appearing mucosa: a case of mistaken identity?

Herr, Harry W; Al-Ahmadie, Hikmat; Dalbagni, Guido; Reuter, Victor E · BJU Int · 2010

case_series · Level IV

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Abstract

To test the frequency of malignancy in normal-appearing urothelium in patients with high-risk bladder cancer, as biopsy of normal-appearing mucosa using standard white-light cystoscopy (WLC) reportedly shows carcinoma in situ (CIS) in some patients with bladder tumours. Cold-cup biopsies of normal-appearing mucosa were obtained by two experienced oncological urologists from 63 patients during transurethral resection of bladder cancers. Each biopsy labelled as 'normal' was interpreted by two expert uropathologists. Each of the biopsies in all 63 patients was interpreted by both urological pathologists as showing normal or benign histology, except that one showed focal CIS. Bladder urothelium appearing normal to expert urological oncologists using standard WLC rarely shows CIS when biopsies are evaluated by experienced uropathologists.

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