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Bladder cancer in cystoscopically normal-appearing mucosa: a case of mistaken identity?
Harry W Herr1, Hikmat Al-Ahmadie, Guido Dalbagni
1Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA. herrh@mskcc.org
Objective:
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.
Patients And Methods:
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.
Results:
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.
Conclusions:
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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