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Complete Response to Intravesical BCG for High-Risk pT1 Bladder Cancer With Lymphovascular Invasion: A Case Report
Anas Saad1, Fahad Mohammad Daraan1, Ibrahim Barghouth1
1Urology Department, University National Hospital, Damascus University, Damascus, Syria, damascusuniversity.edu.sy.
Case Reports in Oncological Medicine
|August 6, 2026
Summary
A rare case of high-grade non-muscle-invasive bladder cancer (NMIBC) in a young adult hookah smoker showed excellent response to Bacillus Calmette-Guérin (BCG) therapy, highlighting bladder-preserving treatment success despite aggressive features.
Area of Science:
- Urology
- Oncology
Background:
- High-grade non-muscle-invasive bladder cancer (NMIBC) with lymphovascular invasion is uncommon in young adults.
- Heavy hookah smoking is a potential risk factor for urothelial carcinoma.
Purpose of the Study:
- To report a rare case of high-grade NMIBC with lymphovascular invasion in a young male patient.
- To evaluate the efficacy of intravesical Bacillus Calmette-Guérin (BCG) therapy in this specific patient profile.
Main Methods:
- Case report of a 27-year-old male with gross hematuria.
- Diagnostic cystoscopy and transurethral resection (TUR) of bladder tumor.
- Pathological analysis confirmed high-grade pT1 urothelial carcinoma with lymphovascular invasion.
- Treatment with six induction doses of intravesical BCG.
Main Results:
- Initial TUR revealed high-grade pT1 urothelial carcinoma with lymphovascular invasion.
- Repeat resection confirmed no residual malignancy.
- The patient remained recurrence-free during follow-up after BCG induction therapy.
Conclusions:
- This case highlights an unusual presentation of high-risk NMIBC in a young patient.
- Intravesical BCG therapy demonstrated excellent early response and disease control.
- Bladder-preserving therapy can be effective despite adverse pathological features in select young patients.