Multicolor FISH (UroVysion) facilitates follow-up of patients with high-grade urothelial carcinoma of the bladder.

The aim of the present prospective study was to assess the diagnostic benefit of UroVysion (Vysis-Abbott Laboratories, Downers Grove, IL) in the follow-up of patients with a history of high-grade non-muscle-invasive urothelial carcinoma of the bladder (NMIBC). An unselected cohort of 25 patients with a history of high-grade NMIBC was prospectively followed up by office-based cystoscopy, cytology, and UroVysion in 210 events. The sensitivity and specificity for standard combined cystoscopy and cytology were 78% and 83%, respectively. UroVysion yielded a considerably higher detection rate with 94% and 93%, respectively. In 89% of the follow-up events of patients with a history of previous carcinoma in situ (CIS) and negative cystoscopy but a positive UroVysion finding, CIS recurrence was noticed within 5 months. UroVysion is a worthwhile approach in patients with previous CIS, a high risk for the development of CIS, or previous unequivocal cytology suggestive of CIS, especially during or shortly after instillation therapy.

Adenocarcinoma of the bladder following nephrogenic adenoma: a case report.

INTRODUCTION: Nephrogenic adenomas are generally considered to be benign lesions, but there remains a risk for malignant transformation. Patients with immunosuppression in particular appear to be at a higher risk of malignant disease. We report a case of post-traumatic nephrogenic adenoma in a young patient without immunosuppression, which transformed into an adenocarcinoma of the bladder. CASE PRESENTATION: A 25-year-old man had a traumatic bladder perforation caused by a car accident. After physical recovery from the accident, he developed a neurogenic bladder and recurrent urinary tract infections. He presented with nephrogenic adenoma of the bladder 18 months after the accident. The adenoma was treated repeatedly with transurethral resections. The initial pathologic findings were benign, however, the last resection revealed that the former benign adenoma had transformed into a moderately differentiated adenocarcinoma of the bladder (tumor present but no invasion, multifocal, no lymph nodes involved, no metastasis, grade 2). He subsequently underwent radical cystectomy and has remained tumor-free for the last 4 years. CONCLUSION: Nephrogenic adenoma is a rare disease with some potential for malignant transformation. However, patients with nephrogenic adenoma under immunosuppression and patients with neurogenic bladder dysfunction appear to be at a higher risk of developing bladder cancer.