Presentation
The patient presented with two episodes of painless hematuria.
Patient Data
Non-contrast and post-contrast images (axial and sagittal views) show an enhancing endophytic mass lesion arising from the base of urinary bladder. The mass is in close proximity to the right vesicoureteric junction and there is mild prominence of the right ureter. However, there is absence of significant hydronephrosis. There is no evidence of extravesical extension of the mass and there is no perivesical fat stranding. There is no significant abdominopelvic lymphadenopathy.
A cystoscopic biopsy was performed and histopathologic examination of the specimen revealed transitional cell carcinoma of the bladder.
Case Discussion
Transitional cell (urothelial) carcinoma is the most common form of bladder cancer, accounting for almost 90% of cases. Squamous cell carcinomas comprise about 3% to 7% of bladder cancers in the United States but are much more common in countries where urinary schistosomiasis is endemic. Adenocarcinomas of the bladder are rare. Bladder cancers are seen in older age groups (50-80 years) and are more common in men.
On cross-sectional imaging, bladder cancers appear as heterogeneously enhancing asymmetric bladder wall thickening or endophytic masses which project into the bladder lumen. In advanced cases, they may invade into the perivesical tissues and adjacent structures.
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