ABSTRACT
In this paper we have presented seven patients with carcinoma in situ of the urinary bladder, a rare intraepithelial form of transitional cell carcinoma of the urinary bladder, described first in 1952. In all patients malignant cells were detected in urine sediment, and the diagnosis was proven histopathologicaly by random biopsies of the urinary bladder. In five patients carcinoma in situ was associated with papillary bladder tumor, while two patients had primary carcinoma in situ. We have emphasized a high rate of irritative urinary symptoms, that can lead to diagnostic mistakes. Three patients had reduced bladder capacity. In all patients a complete response was achieved after local immunotherapy or local chemotherapy. After a follow-up lasting from 23 to 61 months in one patient a recurrent carcinoma in situ was diagnosed, while six patients show no signs of recurrent disease.
Subject(s)
Carcinoma in Situ , Carcinoma, Transitional Cell , Urinary Bladder Neoplasms , Adult , Aged , Carcinoma in Situ/diagnosis , Carcinoma in Situ/therapy , Carcinoma, Transitional Cell/diagnosis , Carcinoma, Transitional Cell/therapy , Female , Humans , Male , Middle Aged , Urinary Bladder Neoplasms/diagnosis , Urinary Bladder Neoplasms/therapyABSTRACT
Medical records of 63 patients operated on for renal cell carcinoma (RCC) between 1986 and 1996 in the Karlovac General Hospital were studied retrospectively. In 23 (36.5%) patients, the tumor was incidentally detected. The median patient age was 62 in the incidental group and 64 years in the symptomatic group (P > 0.05). Ultrasonography was the leading technique for incidental detection of RCC. The median tumor diameter was 6 cm in the incidental group and 9 cm in the symptomatic group (P < 0.001). Incidental carcinomas had a lower stage (P = 0.022) and a lower nuclear grade (P < 0.001) than the symptomatic ones. The incidental cases were associated with a more favorable ploidy status (P = 0.027) and a lower proliferative activity (P = 0.005). The 5-year survival rate was significantly higher in incidental (81.4%) than in symptomatic cases (44.3%) (P = 0.020). Univariate analysis showed that tumor stage, ploidy status, and proliferative activity were good prognostic parameters, while patient age, tumor size, and nuclear grade were not. Tumor stage was the only independent prognostic parameter in multivariate analysis. In conclusion, the incidentally detected RCC show more favorable clinical, histopathological, and flow-cytometric characteristics and their prognosis is significantly better than in symptomatic cases.
