RESUMEN
BACKGROUND: Primary malignant melanoma (PMM) of the bladder represents a very rare clinic-pathologic entity. Given the rarity of the disease, the best treatment option is not well recognized. CASE PRESENTATION: We describe a case of neoplasm of the bladder in a 74 years-old Caucasian man presenting with massive hematuria. Based on clinical, instrumental and histological findings a diagnosis of PMM was made. The patient underwent trans urethral resection of bladder tumor plus intravesical Bacillus Calmette-Guérin. CONCLUSIONS: To make a correct diagnosis, clinical history, endoscopic evaluation, histopathological examination and immunohistochemistry, are necessary. Multidisciplinary evaluation is required to discriminate primary from metastatic malignant melanoma.
Asunto(s)
Melanoma , Neoplasias de la Vejiga Urinaria , Anciano , Tratamiento Conservador , Hematuria/etiología , Humanos , Masculino , Melanoma/diagnóstico , Melanoma/tratamiento farmacológico , Recurrencia Local de Neoplasia , Neoplasias de la Vejiga Urinaria/tratamiento farmacológico , Neoplasias de la Vejiga Urinaria/cirugíaRESUMEN
We reviewed the literature on Bladder Tumor Antigen (BTA Trak and STat) tests to evaluate the usefulness of such tests in the diagnosis and follow-up of bladder cancer and to compare these tests to routine diagnostic tools. We also report our experience on BTA tests in monitoring tumor recurrence of superficial bladder cancer in 194 patients: a correlation between an augmented risk of tumor recurrence and serial measurements of BTA Trak and positive BTA Stat have been identified. According to the available data, BTA tests can be useful in the diagnosis and follow-up of superficial bladder cancer.
Asunto(s)
Neoplasias de la Vejiga Urinaria/diagnóstico , Anciano , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/prevención & control , Neoplasias de la Vejiga Urinaria/terapiaRESUMEN
Transitional cell carcinoma of the bladder is the second most common malignancy of the genitourinary tract. Cystoscopy and urine cytology are the traditional most used techniques for diagnosis and surveillance of superficial bladder cancer. Urine cytology is specific for diagnosis of bladder cancer but sensitivity results not high, particularly in low-grade disease. Voided urine can be easily obtained and therefore additional diagnostic urine tests would be ideal for screening or follow-up of transitional cell carcinoma. A number of studies have focused on the evaluation of urinary markers that hold promise as non-invasive adjuncts to conventional diagnostic or surveillance techniques. In this review we discuss several new urinary markers (test for bladder tumor antigen, NMP22, fibrin degradation products, telomerase, fluorescence in situ hybridization test, flow cytometry) and their role in detection and follow-up of bladder cancer. Most of these markers have higher sensitivity than urine cytology, but voided urine cytology has the highest specificity.