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Transitional cell bladder carcinoma with presentation mimicking ovarian carcinoma
D R Erickson1, D J Dabbs, G J Olt
1Department of Surgery/ Division of Urology, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey 17033, USA.
Gynecologic Oncology
|May 1, 1996
Summary
This case highlights a rare instance where bladder cancer mimicked ovarian carcinoma. Early diagnosis via cystoscopy is crucial, as bladder tumors have a worse prognosis.
Area of Science:
- Oncology
- Urology
- Gynecology
Background:
- Ovarian carcinoma often presents with ascites, pelvic mass, and elevated CA-125.
- Transitional cell carcinoma (TCC) is the most common type of bladder cancer.
- Peritoneal carcinomatosis can occur in both ovarian and bladder cancers.
Observation:
- A patient presented with symptoms suggestive of ovarian carcinoma, including recurrent ascites, a pelvic mass, elevated CA-125, and peritoneal carcinomatosis with transitional cell histology.
- Hematuria was noted, prompting a cystoscopy.
- Cystoscopy revealed the primary tumor to be in the urinary bladder, not the ovaries.
Findings:
- The patient's presentation was initially misdiagnosed as ovarian carcinoma due to extensive peritoneal involvement.
- Transitional cell histology was present in both the peritoneal implants and the bladder tumor.
- This represents an extremely rare presentation of primary bladder cancer.
Implications:
- Accurate identification of the primary tumor site is critical, as bladder cancer with transitional cell histology has a significantly worse prognosis than ovarian carcinoma.
- Cystoscopy is essential for diagnosing patients with hematuria, even when ovarian pathology is suspected.
- Consideration of bladder cancer is warranted in cases of apparent primary peritoneal carcinoma with transitional cell histology.