Neoplasms of the Urinary Bladder: Radiologic-Pathologic Correlation

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.

Excavated mass and double tracking in the sigmoid colon due to colocolic fistula complicating diverticulitis.

“…On the other hand in patients with urothelial tumors, extravesical spread is very common and associates a thickened bladder wall rapidly enhancing with an infiltrated perivesical fat (12). When a fistula does exist, the diagnostic accuracy of cystogram and barium enema is not high (13).…”

Mucinous Cystadenocarcinoma of the Urachus Associated with Pseudomyxoma Peritonei with Emphasis on MR Findings

“…Various cases of pseudomyxoma peritonei caused by mucinous cystic tumors occurring in a region from the appendix to the ovary have been reported, but reports involving the gastrointestinal tract, pancreas, biliary system, urachus, and other entities are rare. [1][2][3][4][5][6][7][8][9][10] Only 11 cases of pseudomyxoma peritonei caused by urachal mucinous cystadenocarcinoma are reported world-wide from 1966 to 2006. [1][2][3][4][5][6][7][8][9][10] Most reports emphasize the pathological interest of this disease, [2][3][4][6][7][8] and onlyˆve include diagnostic images [1][2][3][4][5] -three [2][3][4] with CT images only, one 1 with CT and MR images, and one 5 with CT and US examinationˆndings.…”

Urinary Bladder Cancer: The Current and Potential Role of MR Imaging in Non-Distant Metastatic Lesions

“…Sequences are typically as follows: a large field of view (FOV) of T1-weighted (T1W) imaging on which bladder cancers often appears with an intermediate signal intensity similar to muscle tissue, which actually assists in the identification of infiltration of the perivesical fat by the tumor, lymphadenopathy and bone metastasis. High resolution fast T2-weighted (T2W) imaging can be obtained with a small FOV and a large matrix on which the bladder cancer manifests as a low signal intensity, providing information on tumor depth and involvement of adjacent structures [13][14][15][16]. This is possible because the normal bladder muscle wall manifests itself one or two layers of low (low inner and high outer) signal intensity on T2WI images [17].…”