Mapping of urothelial carcinoma in radical cystectomy specimens

Abstract

Introduction Topographic study of urothelial neoplastic lesions may elucidate the histopathogenesis of multifocality, tumor spread into prostate, urethra, ureter, tumor recurrence and progression. Materials and methods Consecutive specimens of radical cystectomy (RC) for urothelial carcinoma (UC) were serially sectioned in the same horizontal plane into rings of 5-10 mm thickness. Results Fifty RC specimens were compared, 39 from men and 11 from women (19 for superficial UC and 31 for muscle invasive UC). UC was associated with multiple urothelial neoplastic lesions in 36 cases (72%). There was ipsilateral ureteral, contralateral ureteral, prostatic involvement in 16%, 4% and 10% of cases, respectively. Within the urinary bladder, secondary urothelial neoplastic lesions in areas of less than 3 cm, and more than 3 cm (or diametrically opposite) were identified in 33 and 25 cases, respectively. In 30 of 36 cases, satellite neoplastic lesions decreased in size the more distant from the main lesion. Conclusions In a majority of cases (72%), satellite multiple neoplastic lesions were identified in the vicinity of the main lesion, a phenomenon suggestive of soil-seeding phenomenon. The topographic distribution of neoplastic urothelial lesions appears to be random with a field effect in a smaller number of cases.