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1.
Int Braz J Urol ; 45(6): 1270-1274, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31808417

RESUMO

Bladder cancer is a common cancer that may present as superficial, invasive, or metastatic disease. Non-muscle-invasive bladder cancer (NMIBC) represents the majority of bladder cancer diagnoses, but represents a spectrum of disease with a variable clinical course, notably for significant risk of recurrence and potential for progression. NMIBC metastasis to distant organs without local invasion or regional metastasis is a very rare occurrence, so there are limi-ted case reports about early metastasis in the literature.


Assuntos
Carcinoma/secundário , Neoplasias de Cabeça e Pescoço/patologia , Metástase Linfática/patologia , Neoplasias da Bexiga Urinária/patologia , Idoso , Carcinoma/diagnóstico por imagem , Evolução Fatal , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Humanos , Metástase Linfática/diagnóstico por imagem , Masculino , Tomografia Computadorizada por Raios X , Ultrassonografia , Neoplasias da Bexiga Urinária/diagnóstico por imagem
2.
Urologe A ; 58(12): 1443-1450, 2019 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-31741002

RESUMO

Initial clinical and pathological diagnostic workup of urinary bladder cancer is based on cystoscopy, transurethral resection of suspicious lesions, and computed tomography when indicated. Accurate staging is necessary for further therapeutic decision-making. This review summarizes the current status of multiparametric magnetic resonance imaging (mpMRI) and the vesical imaging-reporting and data system (VI-RADS) classification. MpMRI may improve the accuracy of assessment of local tumor invasion compared to conventional imaging alone. VI-RADS standardizes reporting of MRI staging and classifies the likelihood of muscle-invasive bladder cancer into five categories. Preliminary data suggest low interobserver variability. However, prospective multicenter studies are necessary to validate the VI-RADS classification. Progress in functional, molecular, and hybrid imaging may further improve the accuracy of clinical tumor and nodal staging for bladder cancer.


Assuntos
Sistemas de Dados , Neoplasias da Bexiga Urinária , Humanos , Imagem por Ressonância Magnética , Masculino , Invasividade Neoplásica , Estudos Prospectivos , Papel (figurativo) , Neoplasias da Bexiga Urinária/diagnóstico por imagem
3.
Br J Radiol ; 92(1104): 20190401, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31573328

RESUMO

OBJECTIVE: To evaluate role of multiparametric MRI (mp-MRI) in differentiation between invasive and non-invasive bladder cancer and accuracy of vesical imaging reporting and data system (VI-RADS) score. METHODS AND MATERIALS: 50 patients diagnosed as cancer bladder were enrolled in this study, mp-MRI including conventional (T1 weighted imaging and high resolution T2 weighted imaging) and functional sequences (diffusion-weighted imaging and dynamic contrast enhanced-MRI) were done, all data were regrouped to evaluate the accuracy of each separate sequence and mp-MRI in distinguishing non-muscle invasive from muscle-invasive tumors, with VI-RADS score application and comparison with pathological findings, then interobserver agreement for detection of muscle invasion according to mp-MRI and VI-RADS scoring system findings was calculated. RESULTS: Diagnostic accuracy of mp-MRI in differentiation between muscle invasive and non-muscle invasive bladder cancer was (84%) with highest sensitivity (78%), very good agreement between mp-MRI and histopathological data (k = 0.87), and highest area under curve (AUC) reaching 0.83, dynamic contrast enhanced-MRI sequence showed the highest accuracy in muscle invasion detection by (88%), with highest AUC 0.83. Diagnostic accuracy of VI-RADS score in detection of muscle invasion was 84%, with specificity and negative predictive value of 88% and AUC was 0.83. Interobserver agreement was strong as regard diagnostic performance of mp-MRI and VI-RADS scoring for detection of muscle invasion reaching (K = 0.82, p < 0.001) and (K = 0.87, p < 0.001) respectively. CONCLUSION: mp-MRI is considered as comprehensive and effective tool for determination of muscle invasion in cases of urinary bladder cancer. Also VI-RADS scoring system can accurately differentiate between invasive and non-invasive bladder cancer. ADVANCES IN KNOWLEDGE: The VI-RADS system was recently suggested for the uniform evaluation of muscle invasion in cancer bladder by mp-MRI. In this paper, we applied this system to 50 cases to evaluate its ease and compared the results with the histopathological findings for evaluation of its accuracy.


Assuntos
Carcinoma de Células de Transição/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Neoplasias da Bexiga Urinária/diagnóstico por imagem , Bexiga Urinária/diagnóstico por imagem , Adulto , Idoso , Área Sob a Curva , Carcinoma de Células de Transição/patologia , Meios de Contraste , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Liso/diagnóstico por imagem , Músculo Liso/patologia , Invasividade Neoplásica , Estadiamento de Neoplasias , Variações Dependentes do Observador , Curva ROC , Sensibilidade e Especificidade , Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/patologia
5.
Medicine (Baltimore) ; 98(42): e17075, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31626080

RESUMO

Motion-induced artifacts have been a major drawback in bladder cancer imaging. This study is to evaluate the clinical utility of periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) acquisition in improving motion-induced artifacts in T2-weighted (T2W) magnetic resonance imaging (MRI) of bladder cancer at 3T.Sixteen patient MRI exams were included. Using a Likert scale, 2 radiologists independently scored T2W data without and with PROPELLER in terms of artifact severity and tumor visualization. Statistical analysis was done to assess the image quality improvement by PROPELLER and inter-observer variability.Without PROPELLER, the median scores of artifact severity and tumor visualization were 1.5 and 1.5 for reviewer 1, and 2.0 and 2.0 for reviewer 2. With PROPELLER, the scores increased to 3 and 3.5 for reviewer 1, and 3.5 and 3.5 for reviewer 2. Despite the inter-observer variability (κ scores < 0.2), both reviewers found significant improvement in artifacts and visualization (all P < .001).PROPELLER acquisition significantly improved the image quality of T2W-MRI. These initial findings indicate that this technique should be utilized in clinical MRI of the bladder.


Assuntos
Artefatos , Carcinoma de Células de Transição/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Neoplasias da Bexiga Urinária/diagnóstico por imagem , Humanos , Processamento de Imagem Assistida por Computador/métodos , Movimento (Física) , Variações Dependentes do Observador , Estudos Prospectivos , Melhoria de Qualidade , Neoplasias da Bexiga Urinária/patologia
7.
Arch Esp Urol ; 72(8): 831-841, 2019 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-31579042

RESUMO

OBJECTIVE: ICG navigation in cancer surgery may help during pelvic lymphadenectomy. METHODS: We performed a systematic review combining the terms: bladder cancer or radical cystectomy and ICG, and prostate cancer or radical prostatectomy and ICG. We used the PRISMA guidelines recommendations. We describe the populations studied in each work, the pathological results, as well as the parameters specificity, sensitivity and predictive values. RESULTS: In muscle-invasive bladder cancer, 4 case series analyzed the performance of lymphography with ICG. The most accepted injection method is under endoscopic vision. Several punctures are done in the submucosa and the detrusor surrounding the scar. Sentinel nodes were found in up to 92% of patients with a technique sensitivity to find metastases of 88% in the series with largest casuistry. In prostate cancer, we collected data from 11 case series. Nine of them apply transrectal or transperineal dilution immediately before surgery. Sensitivity in the detection of all adenopathies ranged between 44% and 100%. The sensitivity of the technique to know the lymph node stage ranges between 67% and 100%. CONCLUSIONS: There is little experience of ICG-guided lymph node dissedction in bladder tumors. Endoscopic fluorophore injection allows us to find the nodes that drain the infiltrated area. However, the use of this technique is not widespread. In prostate cancer, it is a reproducible and efficient technique for staging patients with prostate cancer.


Assuntos
Metástase Linfática , Linfografia , Neoplasias da Próstata , Neoplasias da Bexiga Urinária , Corantes , Humanos , Verde de Indocianina , Excisão de Linfonodo , Metástase Linfática/diagnóstico por imagem , Masculino , Pelve , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/patologia , Biópsia de Linfonodo Sentinela , Neoplasias da Bexiga Urinária/diagnóstico por imagem , Neoplasias da Bexiga Urinária/patologia
8.
Urologe A ; 58(12): 1435-1442, 2019 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-31531693

RESUMO

The performance of white light (WL) cystoscopy in the diagnostics of bladder cancer can be optimized by the use of modern imaging modalities, such as photodynamic diagnostics (PDD) and narrow band imaging (NBI). Real-time multispectral imaging (rMSI) enables simultaneous imaging of reflectance and fluorescence modalities in multiple spectral bands. We created a multiparametric cystoscopy image by digital overlapping of several modalities, e.g. WL, enhanced vascular contrast (EVC), raw fluorescence mode, protoporphyrin IX and autofluorescence (AF). The technical development and the subsequent clinical implementation of rMSI required a structured preclinical evaluation process, including both ex vivo and in vivo trials before the technology can be applied in patients. This review article presents the phases of testing, validation and the first clinical application of rMSI in urological endoscopy.


Assuntos
Cistoscopia , Imagem de Banda Estreita , Neoplasias da Bexiga Urinária , Testes Diagnósticos de Rotina , Humanos , Tempo , Neoplasias da Bexiga Urinária/diagnóstico por imagem
9.
Cancer Imaging ; 19(1): 59, 2019 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-31455403

RESUMO

BACKGROUND: To evaluate whether readout-segment echo-planar imaging (RS-EPI) can provide better image quality in assessing bladder cancer than single-shot echo-planar imaging (SS-EPI) and to compare quantitative imaging parameters derived from both techniques. METHODS: Seventy patients with bladder lesions were enrolled and underwent diffusion-weighted imaging on a 3 Tesla magnetic resonance scanner using axial RS-EPI and SS-EPI techniques. Two observers independently assessed the susceptibility, detectability, motion artefacts and blurring of the images using qualitative scores. The signal-to-noise ratio (SNR), signal intensity ratio (SIR), contrast-to-noise ratio (CNR) and ADC values of the bladder lesions were measured and compared between the two techniques and between two observers. Qualitative and quantitative comparisons of image quality were performed using the Wilcoxon signed-rank test and paired t-test. In addition, the agreement of the ADC measurements was evaluated using ICC values and Bland-Altman plots. RESULTS: Sixty-eight patients were included in the final analysis. The scores of image susceptibility, detectability and blurring for RS-EPI were significantly higher than those for SS-EPI (all p < 0.05), while the motion artefact was not. There were significant differences between RS-EPI and SS-EPI in the CNR and SIR values (all p < 0.05) but not in the SNR or ADC values (all p > 0.05). The ICC values and Bland-Altman plots also showed excellent agreement between the measured ADC values of the bladder lesions. CONCLUSIONS: The RS-EPI technique provides significantly better image quality in patients with bladder cancer than the SS-EPI technique, without a significant difference in the ADC value.


Assuntos
Imagem de Difusão por Ressonância Magnética/métodos , Imagem Ecoplanar/métodos , Neoplasias da Bexiga Urinária/diagnóstico por imagem , Adulto , Idoso , Imagem de Difusão por Ressonância Magnética/normas , Imagem Ecoplanar/normas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão Sinal-Ruído
10.
BMC Cancer ; 19(1): 763, 2019 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-31375071

RESUMO

BACKGROUND: Bladder leiomyosarcoma is the most frequent mesenchymal neoplasm of the bladder. However, the rarity of the disease and some morphological aspects could give serious problems to differential diagnosis. CASE PRESENTATION: A 86-year-old male patient was referred to our institution to undergo endoscopic low-urinary-tract re-evaluation 2 months after the detection of a "low-grade urothelial neoplasia" in urinary cytology. A TURBT (transurethral resection of bladder tumor) was performed and revealed a tumor extending for 3.5 cm with thin stalk peduncle on the left lateral wall of the bladder, cephalad and lateral to the left ureteral orifice. The exophytic part of the tumor was resected with the underlying bladder wall. Histologically, the tumor showed a quite complex pattern, composed of spindle cells, with often invasion to the surrounding bladder muscular wall, and the presence of numerous multinucleated, osteoclast-like giant cells, scattered throughout the neoplasia. CONCLUSIONS: Here we report a unique case of urinary bladder leiomyosarcoma with osteoclast-like multinucleated giant cells (OGCs). These cells, confounding the morphological aspect, indeed showed an immunohistochemical phenotype of non-neoplastic origin (most likely a histiocyte/macrophage differentiation). We feel that the presence of the OGCs within this tumor is reactive. Nevertheless, more research is necessary to understand the role of OGCs in urinary bladder tumors and leiomyosarcoma, in paticular.


Assuntos
Cistectomia , Células Gigantes/patologia , Leiomiossarcoma/patologia , Leiomiossarcoma/cirurgia , Osteoclastos/patologia , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/cirurgia , Idoso de 80 Anos ou mais , Cistoscopia , Seguimentos , Humanos , Leiomiossarcoma/diagnóstico por imagem , Masculino , Fenótipo , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Neoplasias da Bexiga Urinária/diagnóstico por imagem
11.
Indian J Ophthalmol ; 67(8): 1377-1380, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31332150

RESUMO

A 60-year-old man presented with sudden-onset proptosis of the left eye and intermittent diplopia of 2 months duration. Ophthalmic examination revealed bilateral eyelid retraction, left eye proptosis and a firm, non-tender mass (2 cm × 1.5 cm) in left supero-medial orbit with restricted extraocular movements. Contrast-enhanced computed tomography showed a well-defined, enhancing antero-medial orbital mass which was removed via anterior orbitotomy approach. The histopathology/immunohistochemistry showed adenocarcinoma; metastasis of urothelial origin. The oncology consultation and metastatic workup revealed a urinary bladder carcinoma with distant metastasis. Our patient expired within 6 months of diagnosis. The ophthalmic symptoms due to orbital metastasis may be the first presentation of some cancer patients.


Assuntos
Adenocarcinoma/secundário , Neoplasias Orbitárias/secundário , Neoplasias da Bexiga Urinária/patologia , Adenocarcinoma/diagnóstico por imagem , Diplopia/diagnóstico , Exoftalmia/diagnóstico , Evolução Fatal , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Orbitárias/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Neoplasias da Bexiga Urinária/diagnóstico por imagem
12.
BMJ Case Rep ; 12(7)2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31266754

RESUMO

An 81-year-old man presented to medical services with pelvic pain and evolving urinary retention over 3 months. The patient was found to have a tense glans and penile shaft with surrounding induration consistent with malignant priapism. The extent of the induration included the suprapubic region, scrotum, left iliac region and left flank. A CT scan demonstrated an enhancing, pedunculated lesion arising from the anterior bladder wall measuring 30×31×20 mm. There were multiple enlarged left inguinal lymph nodes. Core biopsies of the subcutaneous tissue on the anterior abdominal wall demonstrated plasmacytoid urothelial carcinoma. The majority of patients with plasmacytoid variant of transitional cell carcinoma will present with >stage 3 bladder disease.


Assuntos
Carcinoma de Células de Transição/diagnóstico por imagem , Carcinoma de Células de Transição/patologia , Neoplasias Penianas/secundário , Priapismo/diagnóstico por imagem , Neoplasias da Bexiga Urinária/diagnóstico por imagem , Neoplasias da Bexiga Urinária/patologia , Idoso de 80 Anos ou mais , Biópsia , Carcinoma de Células de Transição/complicações , Humanos , Masculino , Priapismo/etiologia , Tomografia Computadorizada por Raios X/métodos , Bexiga Urinária/diagnóstico por imagem , Neoplasias da Bexiga Urinária/complicações
13.
Am J Case Rep ; 20: 785-789, 2019 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-31160547

RESUMO

BACKGROUND Advanced urothelial carcinoma has been associated with poor prognosis due to high resistance to chemotherapy and radiation until immunotherapeutic agents, such as atezolizumab, emerged as an option and have shown improved survival. However, atezolizumab is associated with side effects, which were mainly autoimmune. In this case study, we report on a rare case of atezolizumab-induced tumor lysis syndrome. CASE REPORT A 67-year-old female with a primary diagnosis of metastatic urothelial carcinoma who presented to the emergency department with generalized weakness associated with nausea and vomiting 8 days after her first cycle of atezolizumab. Laboratory values showed hyperphosphatemia, hyperuricemia, hypocalcemia, and acute kidney injury consistent with tumor lysis syndrome. CONCLUSIONS In our report, we highlight tumor lysis syndrome as a potential reaction to atezolizumab; a condition that requires prophylaxis and close laboratory monitoring.


Assuntos
Anticorpos Monoclonais Humanizados/efeitos adversos , Carcinoma de Células de Transição/patologia , Síndrome de Lise Tumoral/etiologia , Neoplasias da Bexiga Urinária/tratamento farmacológico , Neoplasias da Bexiga Urinária/patologia , Idoso , Anticorpos Monoclonais Humanizados/administração & dosagem , Biópsia por Agulha , Carcinoma de Células de Transição/diagnóstico por imagem , Carcinoma de Células de Transição/tratamento farmacológico , Progressão da Doença , Serviço Hospitalar de Emergência , Feminino , Cuidados Paliativos na Terminalidade da Vida , Humanos , Imuno-Histoquímica , Monitorização Fisiológica , Invasividade Neoplásica/patologia , Estadiamento de Neoplasias , Tomografia Computadorizada por Raios X/métodos , Síndrome de Lise Tumoral/fisiopatologia , Neoplasias da Bexiga Urinária/diagnóstico por imagem
15.
Prog Urol ; 29(8-9): 449-455, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31230855

RESUMO

INTRODUCTION: The diagnosis of bladder urothelial tumors is based on bladder resection and histological analysis of the specimen. The time to obtain the results of the histological analysis increases the treatment delay. Furthermore, the lack of muscle on the specimen forces the surgeon to practice on other procedure. Full field optical coherence tomography (FFOCT) is a recent imaging technique to analyze tissue. The aim of our study was to evaluate the feasibility and diagnostic accuracy of FFOCT to detect muscle and tumor in bladder resection specimen. PATIENTS AND METHODS: We analyzed with the FFOCT technique bladder resection specimen of 24 consecutives patients. Three readers did the blind analyze of the images, looking for the presence of muscle and tumor on each specimen. Their results were compared with histological analysis to calculate diagnostic accuracy for each reader. RESULTS: Mean sensibilities for the detection of muscle and tumor were respectively 75% and 81%. Mean specificities for the detection of muscle and tumor were respectively 78.3% and 55.3%. CONCLUSIONS: Our results suggest that the FFOCT is feasible to analyze bladder resection specimen. Sensibilities and specificities calculated are encouraging for the detection of muscle and tumor. The accuracy of this detection and early-staging tool should be validated by larger studies. LEVEL OF EVIDENCE: 3.


Assuntos
Cistectomia/métodos , Tomografia de Coerência Óptica/métodos , Neoplasias da Bexiga Urinária/cirurgia , Idoso , Idoso de 80 Anos ou mais , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Neoplasias da Bexiga Urinária/diagnóstico por imagem
16.
BMC Urol ; 19(1): 28, 2019 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-31035981

RESUMO

BACKGROUND: There is no criterion for determining whether female patients operated with cystectomy would benefit from hysterectomy. This study compares the oncological outcomes between female patients receiving uterus preserving cystectomy (UPC) and uterus excision cystectomy (UEC). METHODS: Retrospective review of 121 female patients with urothelial carcinoma of bladder undergoing UPC (n = 63) or UEC (n = 49) at a single institute between January 2006 and April 2017. Individual postoperative follow-up plans were performed for patients through outpatient visits. Overall survival (OS) and progression-free survival (PFS) estimates were analyzed using Kaplan-Meier method and multivariable Cox regression. RESULTS: The median follow-up time was 36 months (interquartile range 16-69). Among patients, 5 (4.1%) had uterus invasion. OS probability (p = 0.939) and PFS probability (p = 0.565) were similar in two groups. In multivariable Cox regression analysis, hysterectomy was not found to be a predictor of OS (hazard ratio 0.908, 95%CI 0.428-1.924, p = 0.801) and PFS (hazard ratio 1.109, 95%CI 0.439-2.805, p = 0.826) after adjusting for age, preoperative clinical stage, pathological stage, pathological nodal stage, neoadjuvant/adjuvant chemotherapy, location of the tumor, and surgical margin. No significant difference of overall survival probability was observed in the patients with organ-confined bladder cancer (p = 0.675) and in patients with no organ-confined bladder cancer (p = 0.695). CONCLUSIONS: The results showed that the rate of uterus invasion was low in patients analyzed in this cohort. It was also found that hysterectomy was not an independent predictor of OS and PFS after radical cystectomy in patients with bladder cancer.


Assuntos
Cistectomia/métodos , Histerectomia/métodos , Neoplasias da Bexiga Urinária/diagnóstico por imagem , Neoplasias da Bexiga Urinária/cirurgia , Idoso , Cistectomia/tendências , Feminino , Seguimentos , Humanos , Histerectomia/tendências , Pessoa de Meia-Idade , Estudos Retrospectivos , Urotélio/diagnóstico por imagem , Urotélio/cirurgia
17.
BMC Urol ; 19(1): 36, 2019 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-31072376

RESUMO

BACKGROUND: Papillary Urothelial Neoplasm of Low Malignant Potential (PUNLMP) are exceptionally rare in the first decade of life (mostly if multifocal) and there is a lack of standardized recommendations for the pediatric age. CASE PRESENTATION: We describe the case of a 9-year-old boy with a diagnosis of PUNLMP, who underwent to cystoscopic lesion removal and later to endoscopic lesion removal and intra-bladder Mitomycin-c (MMC) instillations for relapsed disease. Follow-up investigations at five years showed disease negativity. CONCLUSIONS: Intra-bladder MMC instillation may allow obtaining the complete remission with bladder-sparing for paediatric patients with a high-risk relapsed PUNLMP.


Assuntos
Recidiva Local de Neoplasia/diagnóstico por imagem , Recidiva Local de Neoplasia/terapia , Neoplasias da Bexiga Urinária/diagnóstico por imagem , Neoplasias da Bexiga Urinária/terapia , Urotélio/diagnóstico por imagem , Criança , Cistectomia/métodos , Humanos , Masculino , Urotélio/cirurgia
18.
Prog Urol ; 29(6): 332-339, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31104952

RESUMO

OBJECTIVES: The aim of our study was to assess the impact of blue light cystoscopy with hexaminolevulinate on residual tumor rates at second-look transurethral resection of the bladder (TURB). MATERIAL AND METHODS: Among all patients undergoing TURB in our center between 2012 and 2017, 52 patients had a second-look after a first complete TURB with a delay<3months. We compare patients with standard white light cystoscopy/TURB then second-look blue light cystoscopy/re-TURB (group A, n=30) and patients with blue light cystoscopy/TURB at the initial procedure then white light cystoscopy/re-TURB (group B, n=22). The residual tumor rates at second-look, restaging and changing in therapeutic strategy, as well as recurrence free survival and progression rate were compared. RESULTS: Residual tumor at the time of second-look cystoscopy was detected in 42.3% of cases in our cohort, with a significant difference between the two groups (63.3% in group A versus 0% in group B, <0.001). In group A, 16.7% (5/30) of patients had upstaging and/or upgrading at second-look cystoscopy, resulting in a change in therapeutic strategy in most cases (4/5) while none upstaging was observed in group B. In multivariate analysis, the use of luminofluorescence at the first TURB was the only independent predictive factor of residual tumor (P=0.0031). CONCLUSION: The quality of the initial TURB, when performed by using blue light cystoscopy, had a significant impact on the rate of residual tumor at the second-look resection and could modify therapeutic strategy of NMIBC. LEVEL OF EVIDENCE: 4.


Assuntos
Ácido Aminolevulínico/análogos & derivados , Cistectomia/métodos , Imagem Óptica , Cirurgia de Second-Look , Cirurgia Assistida por Computador , Neoplasias da Bexiga Urinária/diagnóstico por imagem , Neoplasias da Bexiga Urinária/cirurgia , Idoso , Idoso de 80 Anos ou mais , Ácido Aminolevulínico/uso terapêutico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
19.
J Pak Med Assoc ; 69(5): 720-721, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31105295

RESUMO

Urothelial carcinoma is the third most prevalent malignancy in adults, accounting for 2.1 % of all cancerrelated deaths. The highest incidence in the 6th decade of life but it is rare in the paediatric population and its incidence is less than 1% constituting a very rare disease. We report the case of a 13 years old boy, who presented to the outpatient department at The Indus Hospital, Karachi, in May 2017, with the complaint of painless gross haematuria.


Assuntos
Carcinoma de Células de Transição/diagnóstico por imagem , Neoplasias da Bexiga Urinária/diagnóstico por imagem , Administração Intravesical , Adolescente , Idade de Início , Antibióticos Antineoplásicos/uso terapêutico , Carcinoma de Células de Transição/patologia , Carcinoma de Células de Transição/terapia , Cistoscopia , Humanos , Masculino , Mitomicina/uso terapêutico , Ultrassonografia , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/terapia
20.
Vet Radiol Ultrasound ; 60(5): 552-559, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31144408

RESUMO

Feline transitional cell carcinoma (TCC) is a rare neoplasia of cats with an estimated prevalence of 0.18%. Cats with TCC share clinical signs with common pathologies like feline idiopathic cystitis or urinary tract infections. Nonspecific clinical signs include hematuria, pollakiuria, or stranguria. The literature lacks a feline-specific ultrasound description of TCC. The aim of this multicenter retrospective descriptive study was to report ultrasound findings of a collection of feline TCC and then assess if feline TCC and canine TCC have similar ultrasound appearances. It was hypothesized that the ultrasound characteristics would be similar between feline and canine TCC. Ultrasound studies were assessed for tumor shape, number of isolated mural masses, location within the bladder, presence of Doppler signal, echogenicity of urine, mineralization within the mass, extension of the mass into the proximal urethra or ureters, urethral/ureteral obstruction, pyelectasia, and sublumbar lymphadenopathy. Feline studies were compared to 20 cases of confirmed canine TCC. A total of 20 cats with histologically or cytologically confirmed diagnosis of TCC were included. Feline and canine TCC had similarities when viewed using ultrasound. Statistically significant differences were identified for location of the bladder mass (cats were more likely to be mid-body vs trigonal in dogs, P = .011) and urethral extension of the tumor was less likely in cats than dogs (P = .0436). Based on this sample of 20 cats, feline TCC was most commonly a singular, broad-based mass within the mid-body or apex of the urinary bladder.


Assuntos
Carcinoma de Células de Transição/veterinária , Doenças do Gato/diagnóstico por imagem , Doenças do Cão/diagnóstico por imagem , Neoplasias da Bexiga Urinária/veterinária , Animais , Carcinoma de Células de Transição/diagnóstico por imagem , Gatos , Cães , Feminino , Masculino , Ultrassonografia/veterinária , Neoplasias da Bexiga Urinária/diagnóstico por imagem
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