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Published on: May 29, 2015
Management of panurothelial disease in superficial bladder cancer
Miguel Srougi1, Alberto A Antunes, Marcos F Dall'Oglio
1Department of Surgery, Hospital das Clínicas, University of São Paulo Medical School, Brazil. srougi@terra.com.br
Background:
A 59-year-old female presented with a history of recurrent superficial bladder cancer. Since the initial diagnosis 12 years earlier, she had had 12 recurrences, all treated with transurethral resection with adjuvant bacillus Calmette-Guérin and mitomycin C. Pathology samples had always shown Ta grade 1 transitional-cell carcinoma. At the last recurrence, she presented with several papillary lesions throughout the bladder, discovered on control cystoscopy. Transurethral resection revealed a papillary grade 3 transitional-cell carcinoma of the bladder.
Investigations:
Intravenous urography and ureteroscopy.
Diagnosis:
Panurothelial superficial transitional-cell carcinoma.
Management:
Radical cystectomy with total right ureterectomy and distal left ureterectomy. Reconstruction of the urinary tract was performed with the distal ileum detubulized and rearranged in a U shape. A pyeloileal anastomosis and a proximal ureteroileal anastomosis were performed at the right and left sides respectively.