Editorial Comment

Abstract

The authors report the transurethral tru-cut biopsy as an original modality for histopathologically diagnosing muscle-invasive bladder cancer. After comparing the histopathological diagnosis that was made via this method with the diagnosis that was obtained by a cystectomy, the histological type, depth of invasion and grade of bladder cancer appeared to be mostly consistent. It has been explained that this modality is an examination method that can replace transurethral resection of bladder tumor (TURBT) in order to make a histopathological diagnosis of muscle-invasive bladder cancer. This paper raises several questions. Is it possible to make a diagnosis regardless of the tumor size and location? In particular, the removal of tissue is not easy for small tumors and tumors near the bladder neck. Moreover, it is not guaranteed that tissue can be removed from a site that may appear to have the deepest invasion depth. It is believed that the subject in this paper had infiltrating bladder cancer as is evident in the images. This is because all of the cases in this paper are muscle invasive-bladder cancer. However, what are the results in cases in which the diagnosis of muscle-invasive bladder cancer is inconclusive, and what is the result when this method is applied in cases that conversely appear to be superficial bladder cancer (excluding apparent superficial bladder cancer)? These questions need to be clarified. If these questions can be answered, then this modality can potentially become a modality which replaces TURBT as a method of histopathologically diagnosing muscle-invasive bladder cancer.