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Matković A, Ferenc T, Jurjević N, Brkić F, Kavur L, Jurenec F, Mužinić D, Vidjak V. Urothelial carcinoma in a urinary bladder diverticulum: A case report and review of the literature. Radiol Case Rep 2023; 18:1169-74. [PMID: 36660575 DOI: 10.1016/j.radcr.2022.12.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 12/09/2022] [Indexed: 01/13/2023] Open
Abstract
Bladder diverticula are defined as an outpouching of the mucosa into the muscle layer of the bladder wall. There is a well-known link between urinary bladder diverticula and tumors arising within the diverticula. They are rare with an incidence rate of 0.8%-10%. We report an intradiverticular urothelial carcinoma in a 72-year-old man with a known history of multiple episodes of acute urinary retention and urinary tract infections, followed by transurethral resection of the benign prostatic hyperplasia.
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Poletajew S, Krajewski W, Adamowicz J, Kołodziej A, Zdrojowy R, Radziszewski P. Management of Intradiverticular Bladder Tumours: A Systematic Review. Urol Int 2019; 104:42-47. [PMID: 31851992 DOI: 10.1159/000503868] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 09/30/2019] [Indexed: 12/31/2022]
Abstract
The aim of this systematic review was to present available data on diagnostic and therapeutic options in intradiverticular bladder tumour cases. A literature search within the Medline database was conducted in March 2019 with combinations of the following search terms: bladder cancer, bladder tumour, bladder diverticulum, diverticulum, intradiverticular. Seventeen relevant articles were identified. Diagnostic and therapeutic options for intradiverticular bladder tumour follow the general management of bladder cancer patients. The most important differences include a higher rate of non-urothelial histology, higher rate of invasive cancers (stage T1 and higher), no stage T2 disease due to lack of a muscularis propria layer and potential role of partial cystectomy or diverticulectomy in the treatment. Among cystectomized patients, the survival is comparable to general bladder cancer patients after cystectomy. Data on accuracy of imaging and endoscopy in diagnosing intradiverticular bladder tumour are poor. There is no study comparing different treatment modalities in intradiverticular bladder tumour patients. Limitations of this review include low number and low evidence level of available studies, as well as low number and heterogeneity of enrolled subjects. Available literature data cannot be the basis for clinical recommendations in intradiverticular bladder tumour cases. While bladder cancer is the most common urinary tract malignancy and at least 1% of cases are intradiverticular, further research in this field is justified.
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Affiliation(s)
- Sławomir Poletajew
- Department of General, Oncological and Functional Urology, Medical University of Warsaw, Warsaw, Poland, .,Second Department of Urology, Medical Centre of Postgraduate Education, Warsaw, Poland,
| | - Wojciech Krajewski
- Department of Urology and Oncological Urology, Wrocław Medical University, Wrocław, Poland
| | - Jan Adamowicz
- Chair of Urology, Department of Regenerative Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Anna Kołodziej
- Department of Urology and Oncological Urology, Wrocław Medical University, Wrocław, Poland
| | - Romuald Zdrojowy
- Department of Urology and Oncological Urology, Wrocław Medical University, Wrocław, Poland
| | - Piotr Radziszewski
- Department of General, Oncological and Functional Urology, Medical University of Warsaw, Warsaw, Poland
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Moussa M, Abou Chakra M. Urothelial carcinoma arising from a bladder diverticulum containing multiple stones: A case report. Urol Case Rep 2018; 20:80-82. [PMID: 30035095 PMCID: PMC6052197 DOI: 10.1016/j.eucr.2018.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 07/08/2018] [Accepted: 07/10/2018] [Indexed: 11/06/2022] Open
Affiliation(s)
- M Moussa
- Urology Department, Zahraa University Hospital, Beirut, Lebanon
| | - M Abou Chakra
- Faculty of Medical Sciences, Department of Urology, Lebanese University, Beirut, Lebanon
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Anson A, Strohmayer C, Larrinaga JM, Iglesias E, Almela R, Ramírez G, Cervera V. Computed tomographic retrograde positive contrast cystography and computed tomographic excretory urography characterization of a urinary bladder diverticulum in a dog. Vet Radiol Ultrasound 2018; 60:E66-E70. [PMID: 29333663 DOI: 10.1111/vru.12591] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 09/23/2017] [Accepted: 10/02/2017] [Indexed: 11/30/2022] Open
Abstract
A one-year-old intact male German shepherd dog was referred with a 3-month history of dysuria and pollakiuria. Physical examination revealed a large firm mass in the caudal abdomen. Findings from survey radiography, negative contrast cystography, computed tomographic (CT) retrograde positive contrast cystography, and CT excretory urography were consistent with a large urinary bladder diverticulum. An exploratory laparotomy revealed a normal wall appearance in the ventral compartment (true bladder) and marked thinning of the wall in the dorsal compartment (diverticulum). Both ureters inserted into the ventral compartment. The dorsal compartment was excised and histopathology confirmed the diagnosis of urinary bladder diverticulum.
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Affiliation(s)
- Agustina Anson
- Department for Companion Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Carina Strohmayer
- Department for Companion Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
| | | | | | - Ramon Almela
- Kleintierspezialisten Augsburg Überweisungszentrum, Augsburg, Germany
| | - Gustavo Ramírez
- Department of Animal Science, University of Lleida, Lleida, Spain
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Abstract
Patient: Male, 74 Final Diagnosis: Giant intradiverticular bladder tumor with metastasis Symptoms: Hematuria Medication:— Clinical Procedure: — Specialty: Urology
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Affiliation(s)
| | | | | | - Christopher Lee Kheng Siang
- Urology Unit, Department of Surgery , Faculty of Medicine and Health Sciences, Universiti Putra Malaysia , Serdang, Malaysia
| | - Rosna Yunus
- Department of Pathology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
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7
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Chen H, Lin Y, Cheng Y. Urothelial carcinoma arising within bladder diverticulum—Report of a case and review of the literature. Urological Science 2016; 27:177-80. [DOI: 10.1016/j.urols.2015.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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8
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Affiliation(s)
- Li-Ying Fu
- Department of Pathology, Yale University School of Medicine, New Haven, Connecticut
| | - Adebowale J Adeniran
- Department of Pathology, Yale University School of Medicine, New Haven, Connecticut
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Di Paolo PL, Vargas HA, Karlo CA, Lakhman Y, Zheng J, Moskowitz CS, Al-Ahmadie HA, Sala E, Bochner BH, Hricak H. Intradiverticular bladder cancer: CT imaging features and their association with clinical outcomes. Clin Imaging 2015; 39:94-8. [PMID: 25457532 DOI: 10.1016/j.clinimag.2014.10.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 09/12/2014] [Accepted: 10/09/2014] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To evaluate if computed tomographic (CT) features of intradiverticular bladder cancer can predict clinical outcome. METHODS Retrospective study of 34 patients with intradiverticular bladder cancer. Two radiologists independently evaluated all CT exams. RESULTS CT tumor length and width were significantly associated with survival for both readers [hazard ratios (HRs) 1.31-1.62, P<.001-.043]. No other tumor features were significantly associated with survival. The interreader agreement for the assessment of CT features was fair to substantial (k=0.34-0.78, concordance correlation coefficient=0.56-0.66). There was no association between transurethral resection pathology stage and survival (HR 2.10, P=.21). CONCLUSIONS In patients with intradiverticular bladder cancer, the tumor length and width measured on the pretreatment CT predicted survival.
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Abstract
Detection of muscle invasion is a critical aspect in management of urinary bladder cancer. MR imaging has the potential and promise of delivering this premise noninvasively. This article reviews the current status of MR imaging in evaluation of bladder cancer. Also discussed are other important neoplastic and nonneoplastic conditions affecting the bladder.
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Affiliation(s)
- Syed Arsalan Raza
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
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Shebel HM, Elsayes KM, Abou El Atta HM, Elguindy YM, El-Diasty TA. Genitourinary schistosomiasis: life cycle and radiologic-pathologic findings. Radiographics 2012; 32:1031-46. [PMID: 22786992 DOI: 10.1148/rg.324115162] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Genitourinary schistosomiasis is produced by Schistosoma haematobium, a species of fluke that is endemic to Africa and the Middle East, and causes substantial morbidity and mortality in those regions. It also may be seen elsewhere, as a result of travel or immigration. S haematobium, one of the five fluke species that account for most human cases of schistosomiasis, is the only species that infects the genitourinary system, where it may lead to a wide spectrum of clinical symptoms and signs. In the early stages, it primarily involves the bladder and ureters; later, the kidneys and genital organs are involved. It rarely infects the colon or lungs. A definitive diagnosis of genitourinary schistosomiasis is based on findings of parasite ova at microscopic urinalysis. Clinical manifestations and radiologic imaging features also may be suggestive of the disease, even at an early stage: Hematuria, dysuria, and hemospermia, early clinical signs of an established S haematobium infection, appear within 3 months after infection. At imaging, fine ureteral calcifications that appear as a line or parallel lines on abdominopelvic radiographs and as a circular pattern on axial images from computed tomography (CT) are considered pathognomonic of early-stage schistosomiasis. Ureteritis, pyelitis, and cystitis cystica, conditions that are characterized by air bubble-like filling defects representing ova deposited in the ureter, kidney, and bladder, respectively, may be seen at intravenous urography, intravenous ureteropyelography, and CT urography. Coarse calcification, fibrosis, and strictures are signs of chronic or late-stage schistosomiasis. Such changes may be especially severe in the bladder, creating a predisposition to squamous cell carcinoma. Genital involvement, which occurs more often in men than in women, predominantly affects the prostate and seminal vesicles.
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Affiliation(s)
- Haytham M Shebel
- Department of Radiology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
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13
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Neuzillet Y, Comperat E, Rouprêt M, Larre S, Roy C, Quintens H, Houede N, Pignot G, Wallerand H, Soulie M, Pfister C. Tumeurs de vessie intradiverticulaires : revue du Comité de cancérologie de l’Association française d’urologie. Prog Urol 2012; 22:495-502. [DOI: 10.1016/j.purol.2012.03.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Revised: 03/02/2012] [Accepted: 03/26/2012] [Indexed: 11/23/2022]
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Sakhri L, Mennecier B, Jacqmin D, Di Marco A, Schumacher C, Chenard MP, Bergmann E, Quoix E. [Atypical metastatic site of lung adenocarcinoma]. Rev Pneumol Clin 2011; 67:375-379. [PMID: 22137284 DOI: 10.1016/j.pneumo.2011.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2010] [Revised: 01/24/2011] [Accepted: 01/29/2011] [Indexed: 05/31/2023]
Abstract
The case concerns a 40 years old smoker male, treated for an adenocarcinoma of the left upper lobe, metastatic in muscle extended to the right femur cortex. The patient had first a surgical excision of the mass of the thigh, an intramedullary femoral nailing, and six courses of chemotherapy (cisplatin-vinorelbine) with concurrent thoracic radiotherapy. This treatment led to disease stability. One year later, hematuria revealed a bladder tumor. Cystoscopy with biopsy concluded to an adenocarcinoma pulmonary origin. The PET-scanner showed an uptake of the bladder mass, a hypermetabolic right adrenal gland and subcutaneous left shoulder nodule. The patient had a partial cystectomy associated with enterocystoplasty and left ureteral reimplantation, plus excision of the subcutaneous nodule located in the left shoulder and a right adrenalectomy during the same time. All of the sites were metastasis from adenocarcinoma of pulmonary origin. A salvage chemotherapy was initiated. In the vast majority of cases, bladder metastasis as primary bladder tumours is revealed by hematuria, cystitis or sometimes vague pelvic pain. Our case is a very unusual bladder metastatic site from lung cancer. We will discuss the different procedures and the therapeutic strategies on the basis of the published data.
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Affiliation(s)
- L Sakhri
- Service de pneumologie, nouvel hôpital Civil, Strasbourg, France
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Patil VV, Wang ZJ, Sollitto RA, Chuang K, Konety BR, Hawkins RA, Coakley FV. 18 F-FDG PET/CT of Transitional Cell Carcinoma. AJR Am J Roentgenol 2009; 193:W497-504. [DOI: 10.2214/ajr.08.1945] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Panebianco V, Sciarra A, Di Martino M, Bernardo S, Vergari V, Gentilucci A, Catalano C, Passariello R. Bladder carcinoma: MDCT cystography and virtual cystoscopy. ACTA ACUST UNITED AC 2010; 35:257-64. [DOI: 10.1007/s00261-009-9530-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2009] [Accepted: 04/20/2009] [Indexed: 11/26/2022]
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Hinojosa D, Joseph UA, Wan DQ, Barron BJ. Inguinal herniation of a bladder diverticulum on PET/CT and associated complications. Clin Imaging 2008; 32:483-6. [PMID: 19006780 DOI: 10.1016/j.clinimag.2008.03.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2007] [Revised: 03/10/2008] [Accepted: 03/21/2008] [Indexed: 11/20/2022]
Abstract
Inguinal herniation of the urinary bladder is not routinely seen in clinical practice. Most patients are asymptomatic and are diagnosed incidentally on diagnostic imaging or during the course of surgical repairs. Bladder herniation has previously been reported on ultrasonography and computed tomography, but not on positron emission tomography (PET) imaging. We report an interesting case of bladder herniation and describe the findings observed by PET as well as the complications associated with this abnormality.
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Machida H, Ueno E, Nakazawa H, Fujimura M, Kihara T. Computed tomographic appearance of urachal carcinoma associated with urachal diverticulum misdiagnosed by cystoscopy. ACTA ACUST UNITED AC 2007; 33:363-6. [PMID: 17639381 DOI: 10.1007/s00261-007-9256-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Urachal carcinoma associated with the urachal diverticulum is rare. We present a surgical case of this condition that was initially diagnosed as bladder urothelial carcinoma by cystoscopy, but was then correctly diagnosed by computed tomography (CT). Whereas the CT appearance mimicked that of bladder cancer, accurate localization of the lesion and identification of the median umbilical ligament clarified diagnosis.
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Affiliation(s)
- Haruhiko Machida
- Departments of Radiology, Tokyo Women's Medical University, Medical Center East, 2-1-10 Nishiogu, Arakawa-ku, Tokyo, 116-8567, Japan.
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21
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Jung SI, Kang TW, Shin SS, Kwon DD, Park K, Ryu SB. Usefulness of Virtual Cystoscopy using a 64-channel Multidetector-row Computed Tomography Scanner for Detecting Bladder Tumors. Korean J Urol 2007. [DOI: 10.4111/kju.2007.48.4.383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Seung Il Jung
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
| | - Taek Won Kang
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
| | - Sang Soo Shin
- Department of Diagnostic Radiology, Chonnam National University Medical School, Gwangju, Korea
| | - Dong Deuk Kwon
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
| | - Kwangsung Park
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
| | - Soo Bang Ryu
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
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Wong-You-Cheong JJ, Woodward PJ, Manning MA, Sesterhenn IA. From the Archives of the AFIP: neoplasms of the urinary bladder: radiologic-pathologic correlation. Radiographics 2006; 26:553-80. [PMID: 16549617 DOI: 10.1148/rg.262055172] [Citation(s) in RCA: 146] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
In the United States, primary bladder neoplasms account for 2%-6% of all tumors, with bladder cancer ranked as the fourth most common malignancy. Ninety-five percent of bladder neoplasms arise from the epithelium; the most common subtype is urothelial carcinoma, which accounts for 90% of cases. Squamous cell carcinoma accounts for 2%-15%, with rates varying widely according to geographic location. Adenocarcinoma (primary bladder, urachal, or metastatic) represents less than 2%. Bladder cancer typically occurs in men aged 50-70 years and is related to smoking or occupational exposure to carcinogens. Most urothelial neoplasms are low-grade papillary tumors, which tend to be multifocal and recur but have a relatively good prognosis. High-grade invasive tumors are less common and have a much poorer prognosis. Squamous cell carcinoma and adenocarcinoma occur in the setting of chronic bladder infection and irritation. Mesenchymal tumors represent the remaining 5% of bladder tumors, with the most common types being rhabdomyosarcoma, typically seen in children, and leiomyosarcoma, a disease of adults. Rarer mesenchymal tumors include paraganglioma, lymphoma, leiomyoma, and solitary fibrous tumor. Although imaging findings are not specific for these tumors, patterns of growth and tumor characteristics may allow differentiation. For accurate staging, computed tomography and magnetic resonance imaging are the modalities of choice.
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Affiliation(s)
- Jade J Wong-You-Cheong
- Department of Diagnostic Radiology, University of Maryland School of Medicine, 22 S Greene St, Baltimore, MD 21201-1595, USA.
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Abstract
Virtual cystoscopy is a promising new technique based on computer-simulated rendering of the inner surface of the urinary bladder using volumetric magnetic resonance (MR) imaging data, thus enabling maneuvers that normally are not possible with conventional cystoscopy. Due to several distinct advantages over conventional cystoscopy such as minimal invasiveness, evaluation of the urethral orifice from a cranial point of view and an opportunity to observe diverticula formations and the inner urethral space, gadolinium-enhanced MR cystoscopy has a great potential for competing with conventional cystoscopy under some clinical circumstances. The recent improvement in MR scanners has significantly facilitated virtual cystoscopic evaluation of the urinary bladder lumen by MR imaging. Volumetric data associated with powerful postprocessing procedures allow imaging of the inner urinary bladder surface with excellent detail. In this article, imaging techniques and clinical applications of gadolinium-enhanced virtual MR cystoscopy are presented.
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Affiliation(s)
- E Suleyman
- Department of Radiology, Istanbul University, Istanbul, Turkey.
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Affiliation(s)
- Eduardo J Matta
- Department of Radiology, Ochsner Clinic Foundation, Jefferson, La., USA.
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25
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Browne RFJ, Murphy SM, Grainger R, Hamilton S. CT cystography and virtual cystoscopy in the assessment of new and recurrent bladder neoplasms. Eur J Radiol 2005; 53:147-53. [PMID: 15607867 DOI: 10.1016/j.ejrad.2004.02.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2003] [Revised: 01/30/2004] [Accepted: 02/02/2004] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To determine if CT cystography and virtual cystoscopy have a role in the assessment of neoplasms of the urinary bladder. MATERIAL AND METHODS Twenty five adults suspected of having bladder tumours underwent CT cystography. Twenty three had subsequent virtual cystoscopic reconstructions from the axial data. The examinations were reviewed by two radiologists and the findings were correlated with those at conventional cystoscopy. RESULTS Seventeen masses larger than 0.5 cm were identified by CT cystography in 16 patients. Two patients had normal CT cystography, but one had small recurrent neoplasms on conventional examination. Seven patients had nodular mucosal irregularities which were subsequently shown to be neoplastic in three. Accuracy for diagnosis of neoplasm in all patients was 88%. CONCLUSION CT cystography is very accurate at identifying masses larger than 0.5 cm and can show mucosal abnormalities as small as 2 mm. It is minimally invasive and can be diagnostic when conventional cystoscopy is inconclusive. It can indicate appropriate areas for assessment and biopsy at conventional examination. Virtual cystoscopy gave comparable views to conventional cystoscopy, but did not add diagnostic information. It is not likely to replace conventional cystoscopy, but may be helpful in occasional circumstances where the latter is inconclusive, or can not be performed.
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Affiliation(s)
- R F J Browne
- Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland
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26
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Abstract
MR imaging is a useful modality for evaluating diseases of the bladder. MR imaging can detect and stage bladder cancer by determining the presence and depth of muscle invasion. Direct multiplanar imaging and superb soft-tissue contrast make MR imaging an ideal modality for evaluating less common neoplastic diseases of the bladder, such as urachal carcinoma, and tumors that develop within bladder diverticula. Dynamic breath-held fast T2-weighted imaging can evaluate for cystocele and other components of pelvic floor relaxation.
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Affiliation(s)
- Gautham K Mallampati
- Hospital of the University of Pennsylvania, 3400 Spruce Street, 1st Floor Founders-MRI, Philadelphia, PA 19104-4283, USA
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27
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Berzeg S, Baumgart E, Beyersdorff D, Lenk S, Kopka L. Late complication of Boari bladder flap. Eur Radiol 2003; 13:1604-7. [PMID: 12835973 DOI: 10.1007/s00330-002-1599-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2002] [Revised: 05/24/2002] [Accepted: 06/12/2002] [Indexed: 10/26/2022]
Abstract
A very rare late complication of Boari bladder flap repair with development of pseudodiverticulum and recurrent genitourinary tract infection secondary to vesicoureteral reflux is presented. Radiologic evaluation of the patient comprised intravenous pyelography (IVP), micturating cystourethrogram, cystoscopy, and multislice computed tomography (MSCT).
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Affiliation(s)
- Semin Berzeg
- Department of Radiology, Charité Campus Mitte, Schumannstrasse 20/21, 10117 Berlin, Germany.
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28
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Almeida Junior JGD, Santos MLDO, Vabo TPD, Silva KGCD, Melo ASAD, Moreira LBM, Muniz MAS, Szerman A, Marchiori E. Carcinoma de células transicionais do trato urinário: aspectos da tomografia computadorizada. Radiol Bras 2003. [DOI: 10.1590/s0100-39842003000100005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Embora relativamente incomum, o carcinoma de células transicionais do trato urinário é o segundo tumor mais freqüente do rim. Neste trabalho foram analisadas, de forma retrospectiva, as tomografias computadorizadas de dez pacientes com carcinoma de células transicionais confirmado por exame histopatológico. A bexiga foi acometida em 60% dos casos, o sistema pielocalicinal em 60% e o ureter em 10% deles. Lesões sincrônicas estiveram presentes em 40% das vezes. Os aspectos encontrados foram lesões vegetantes, espessamento da parede do ureter e lesões infiltrativas do rim. Foram descritos dois casos de tumores calcificados e um carcinoma de células transicionais surgindo no interior de um divertículo de bexiga. A tomografia computadorizada detectou extensão local do tumor em 80% dos pacientes e lesão a distância em 20%. A tomografia computadorizada permitiu caracterizar a extensão da doença, localmente e a distância, possibilitando que um grupo selecionado de pacientes pudesse ser tratado de forma conservadora.
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29
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Lämmle M, Beer A, Settles M, Hannig C, Schwaibold H, Drews C. Reliability of MR imaging-based virtual cystoscopy in the diagnosis of cancer of the urinary bladder. AJR Am J Roentgenol 2002; 178:1483-8. [PMID: 12034625 DOI: 10.2214/ajr.178.6.1781483] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Our purpose was to evaluate MR imaging-based virtual endoscopy in patients with urinary bladder cancer compared with conventional cystoscopy as the gold standard. SUBJECTS AND METHODS Twenty-five patients with urinary bladder cancer diagnosed on conventional cystoscopy underwent MR imaging of the pelvis. Patients were examined without external bladder filling or administration of IV contrast medium. No medications were administered. The data obtained by MR imaging were reconstructed for virtual endoscopy on a workstation. The locations and sizes of tumors were individually determined and compared with results of conventional cystoscopy. RESULTS Twenty-four patients were evaluated; one patient's examination was excluded from analysis because of metallic artifacts. Seventeen patients were diagnosed with a single bladder tumor. Five patients had two tumors each, and two patients had three tumors. Tumor diameter ranged from 0.4 to 6.4 cm. Thirty (90.9%) of 33 tumors detected on cystoscopy were visualized with virtual endoscopy. The detection rate for 23 tumors of 1 cm or greater was 100%. Difficult conditions for conventional cystoscopy, including hematuria, anterior wall involvement, and urethral strictures, had no deleterious impact on virtual cystoscopy. Difficulties in detection on virtual endoscopy were associated with flat bladder tumors with minimal surface elevation. CONCLUSION The results of this study suggest a high reliability in the diagnosis of urinary bladder cancer by MR imaging-based virtual cystoscopy-a noninvasive method, independent of medication or contrast enhancement, that may be of value for screening, primary diagnosis, and surveillance. Virtual MR cystoscopy may be indicated when conventional cystoscopy cannot be performed or is ineffective.
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Affiliation(s)
- Markus Lämmle
- Department of Radiology, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, D-81675 Munich, Germany
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Fekak H, Rabu R, Joual A, Bennani S, Moufid K, Sarf S, Debragh A, el Mimu M, Benjelloun S. [Intradiverticular bladder tumors. Three case reports]. Ann Urol (Paris) 2002; 36:53-7. [PMID: 11859579 DOI: 10.1016/s0003-4401(01)00072-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The bladder tumours in vesical diverticula is rare, and the poor prognosis, because it was often with early invasion. We reported three cases of bladder tumours in vesical diverticula, with delay of diagnosis two, eight and twelve months respectively. The radiology exploration suspected the diagnosis and the histology biopsy confirmed a diagnosis of primary transitional cell carcinoma in two cases: PTa GI and T2 GII, and in an other case it was a invasive epidermoid carcinoma. The first patient was dead by urethral resection of the bladder tumour. The second required a cytoprototectomy and the last patient. The treatment consisted of radiotherapy and chemotherapy. We insisted of the particularity diagnosis, histology and therapeutic for bladder tumour in vesical diverticula and the early diagnosis in order to have a good prognosis.
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Affiliation(s)
- H Fekak
- Service d'urologie, CHU Ibn Rochd, Casablanca, Maroc
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Abstract
Cystoendoscopic examination and standard radiological techniques occasionally fail to correctly establish that a pelvic mass is due to carcinoma arising within a urinary bladder diverticulum. MR imaging in oblique planes can facilitate the diagnosis in such cases by demonstrating the neck of the diverticulum. Also, T2-weighted images allow differentiation between tumor within a diverticulum and a necrotic extravesical mass.
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Affiliation(s)
- S M Durfee
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA
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