Invasive urothelial carcinoma

Invasive urothelial carcinoma 

Updated: 01/27/2021

© Jun Wang, MD, PhD

General features
  • Most common bladder tumor
  • More common in >50, cigarette smoker, men, urban
  • Multifocal along urinary tract
Risk factors
  • Cigarette smoking
  • Industrial exposure to arylamines and aniline dyes
  • Long term phenacetin use in young women
  • Cyclophosphamide
  • Chronic irritation
  • HPV
Clinical presentations
  • Painless hematuria
  • Obstruction if near ureteral orifices
  • Irritative bladder symptoms: Dysuria, urgency, etc
  • Atypical cells in urine
Key morphological features
  • Mass, with or without ulceration
  • Nest, cord of atypical urothelial cells, low or high grade
  • Invasion into stroma
  • Positive for uroplakin, etc
Genetics
  • Aneuploidy
  • Monosomy 9, 9p-, etc
  • Low grade papillary: FGFR3, PIK3CA, STAG2
  • High grade: p53, RB1, Her2, PTEN, etc
Treatment
  • Surgery: cystectomy
  • Chemotherapy


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