Transitional cell carcinoma with abladder diverticulum: CT findings and pathologic correlation

Mesane divertikülü içerisinde gelişen değişici hücreli karsinom vakası sunulmaktadır. On yıl önce prostat karsinomu tanısı alan 71 yasında erkek hasta hematüri ve idrarda yanma hissi ile başvurdu. Kontrastlı BT IVP sonucunda bir mesane divertikülü içerisinde malignansi açısından şüpheli küçük polipoid kitle saptandı. Sistoskopi sırasında lezyondan biopsi örnekleri alındı ve patoloji sonucu muskularis propria tabakasının izlenmediği yüksek dereceli papiller üretelial karsinom olarak geldi. Negatif metastaz taraması sonrası radikal sistektomi yapıldı ve hasta takibe alındı. Bir vaka nedeniyle divertiküler neoplazinin klinikopatolojik özellikleri ve BT nin özellikle gözden kaçan vakaların tanısında ve evrelemedeki önemi hatırlatılmaktadır.

Mesane divertikülü içerisinde gelişen değişici hücreli karsinom: BT bulguları ve patolojik korelasyon

A case of transitional cell carcinoma within a bladder diverticulum is presented. A 71 -year-old man with a previous history of prostate carcinoma presented with hematuria and a burning sensation during urination. CT IVP detected a small polypoid mass within a bladder diverticulum, suspicious for a malignancy. A biopsy was performed during cystoscopy and pathology revealed a high grade papillary urothelial carcinoma with no muscularis propria identified. He underwent radical cystectomy and was followed up for recurrence. The clinicopathologic characteristics of diverticular neoplasms and the importance of CT in the diagnosis of overlooked lesions and staging are reviewed.

PDF

___

1-Lawrence WW (Ed): Current Surgical Diagnosis and treatment, 10th ed. Englewood Cliffs, New Jersey, Prentice-Hall, 1994; 952-954.
2-Melekos MD, Asbach HW, Barbalias GA: Vesical diverticula: etiology, diagnosis tumorgenesis and treatment. Analysis of 74 cases. Urology 1987; 30:453-457.
3-Wasserman NF, Zhang G, Posalaky IP, Reddy PK: Ureteral pseudodiverticula: frequent association with uroepitelial malignancy. Am JRoent 1991; 157: 69-72.
4-Gerridzen RG, Futter NG: Ten year review of vesical diverticula. Urology 1982; 20:33-35.
5-Peterson LJ, Paulson DF, Glenn JF: The histopathology of vesical diverticula. JUrol 1973; 110: 62-64.
6-Lowe FC, Goldman SM, Oesterling JE: Computerized tomography in evaluation of transitional cell carcinoma in bladder diverticula. Uroradiology 1989; 34: 390-395.
7-Baniel J, Vishna Tali: Primary transitional cell carcinoma in vesical diverticula. Urology 1997; 50: 697-699.
8-Matta EJ, Kenney AJ, Barre GM, Vanlangendonck RM Jr: Intradiverticular bladder carcinoma. Radiographics 2005; 25: 1397-1403.
9-Abeshouse BS, Goldstein RG: Primary carcinoma in a diverticulum of the bladder: a report of four cases and a review of the literature. J Urol 1943; 49 534-536.
10-Knappenberger ST, Uson AC, Melicow MM: primary neoplasm occurring in vesical diverticula: report of 18 cases. J Urol 1960; 83: 153-159.
11-Donalski M, White EM, Ghahremani GG, Patel SK: Carcinoma arising in urinary bladder diverticula: Imaging findings in six patients. AJR 1993; 161:817-820.
12-Yağci C, Atasoy C, Fitoz S, Akyar S: Cross-sectional imaging findings in intradiverticular tumors: Case report. Tani Girişim Radyol 2003 Dec; 9: 452-455
13-Seidelman FE, Cohen WN, Bryan PJ: Computed tomographic staging of bladder neoplasms. RadClin North Am 1977; 15: 419-440.
14-Hamlin DJ, Cockett ATK: Modification for computerized tomographic staging of infiltrative bladder carcinoma. J Urol 1980; 123: 489-491.
15-Vock P, Haertel M, Fuchs WA et al: Computerized tomography in staging of carcinoma of the urinary bladder: Br JUrol 1982; 54: 158-163.
16-Redman JF, McGinnis TB, Bissada NK: Management of neoplasms in vesical diverticula. Urology 1976; 50: 492-494.
17-Rubin P: Current concepts in genitourinary oncology: a multidisciplinary approach. J Urol 1971 106: 315-338.
18-Golijanin D, Yossepowitch O, Beck SD et al: Carcinoma in a bladder diverticulum: Presentation and treatment outcome. The Journal of Urology 2003; 170: 1761-1764.