Nonurothelial bladder cancer and rare variant histologies

At present, radical cystectomy is a mainstay in the management of all bladder cancers, whether of conventional urothelial histology or variant. However, in the case of some variants, it is clearly not enough and multimodal therapy is an imperative. In other cases, systemic therapy might be ineffective or even detrimental if it leads to delay in surgery (ie, squamous cell carcinoma). Thus, identification of variant histology is a critical part of bladder cancer staging because such histology may require appropriately tailored therapy.