Primary Neoplasms Occurring in Vesical Diverticula: A Report of 18 Cases

Knappenberger, Sam T.; Uson, Aurelio C.; Melicow, Meyer M.

doi:10.1016/s0022-5347(17)65675-1

Cited by 66 publications

(11 citation statements)

References 9 publications

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“…These factors act as promoters of carcinogenesis [2,10,11] . According to Kappenberger et al [12] , when a tumor and a diverticulum coexist in the bladder, the tumor is likely to be within the diverticulum. However, this theory does not explain the same recurrence rate for intradiverticular and nondiverticular neoplasms in the bladder or why transitional cell carcinoma occurs and recurs at sites remote from the diverticulum in many patients [5,9] .…”

Section: Discussionmentioning

confidence: 99%

“…Randomized prospective studies do not exist. According to Baniel et al [14] , superfi cial intradiverticular tumors may be treated conservatively, but when dealing with invasive bladder diverticula tumors (T1), disease management should probably be aggressive (radical cystectomy versus diverticulectomy), although the small number of cases precludes a clear recommendation of cystectomy versus local resection [11,12,15] . Kelalis and McLean [10] described a series of 19 patients with diverticular neoplasms treated primarily with surgical excision in which they noted a cancer-specifi c survival of 16% at 2 years.…”

Section: Discussionmentioning

confidence: 99%

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Diverticular Carcinoma of the Urinary Bladder: Diagnosis and Treatment Problems

Haecker

Riedasch²,

Langbein³

et al. 2005

Med Princ Pract

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Objectives: To report a case of a primary carcinoma arising in a vesical diverticulum. Clinical Presentation and Intervention: A 59-year-old male patient presented with painless macrohematuria. A primary carcinoma arising in a vesical diverticulum was detected with cystoscopy and confirmed with rectal endosonography and computer tomography. and radical cystoprostatovesiculectomy with ileal conduit was performed. Chemotherapy with cisplatin and methotrexate followed. The patient died of an acute cardiac event in the 4th postoperative month.Conclusion: This report illustrates that in a case of a closed opening of a bladder diverticulum, rectal endosonography and computer tomography do provide additional support for making a diagnosis of a hidden tumor in the diverticulum.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Diverticular Carcinoma of the Urinary Bladder: Diagnosis and Treatment Problems

Haecker

Riedasch²,

Langbein³

et al. 2005

Med Princ Pract

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“…The reported incidence varied from 0.8 to 10.8% [1][2][3][4][5][6][7][8][9], In 1883, Williams [10] presented the autopsy finding of a sarcoma as the first recorded case of malignancy within a vesical diverticulum. In 1896, Targett [11] de scribed the first surgical specimen of neoplasm arising in a bladder diverticulum.…”

mentioning

confidence: 99%

“…Our study showed that about 43% of tumors had peridiverticular invasion, especially for high grade ones. The poor prognosis also is advanced by frequent delay in diagnosis [1,2,5,8,14,16,17].…”

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confidence: 99%

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Intradiverticular Tumors of the Bladder: Surgical Implications - An Eleven-Year Review

Huang²,

Lee³

et al. 1993

Eur Urol

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Carcinomas in vesical diverticula: The role of ultrasound

Sáez

Peña

Martínez

et al. 1985

J of Clinical Ultrasound

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The vesical diverticulum (VD) consists of a cavity formed by herniation of the bladder mucosa through the muscular wall joined by a constricted neck to the bladder cavity proper.' The VD tends to occur in areas of congenital weakness of the muscular wall, and for that reason it is most common in the region around the ureteral meati or in the posterolateral surface of the bladder.2-4Vesical carcinoma (VC) is the most important malignant tumor of the urinary tract.5 The average ma1e:female ratio regarding VC is around 3:1.6 As for the VD, this ratio is 9:1.3,7 For this reason, the large majority of the reported cases of VC located in the VC are in males.The incidence of VC found within the VD ranges from 0.8% to 7%.7 The average age of male patients with VD is around 577 while that of patients with both VC and VD is 66, which is similar to the age at which extradiverticular bladder carcinoma appears.Persistent lower urinary tract obstruction is a causative factor for both VC and VD, their main etiologies being enlargement of the prostate and bladder neck s t e n~s i s .~ Other factors that have been statistically demonstrated as having an influence on the onset of VC are chronic inflammation: tobacco smoking, and occupational exposure to certain dyes and other products.6The diagnosis of these tumors frequently yields negative results with traditional m e t h o d~l~~'~ since it is often necessary to perform all the available diagnostic procedures to demonstrate the filling defect within the VD.9Three cases of VC in VD are reported here, with special remarks on the role of real-time suprapubic ultrasound in both diagnosis and staging. CASE REPORTSOur three male patients were 78,55, and 57 years old, respectively. In all three cases predisposing factors led to the development of VC and VD. Cases I and I1 had chronic lower urinary tract obstruction caused by an enlarged prostate that required transurethral resection 6 years previously. In case I1 a papilloma was resected 5 years previously. Case I11 was a heavy smoker and had urinary tract infection. Every patient had painless macroscopic hematuria as the main complaint. Apart from that, clinical and analytical evaluations were normal. The diagnostic procedures yielded the following results. Case IMild bilateral ectasia was found. A large VD on the right posterolateral surface of the bladder revealed a filling defect inside.A large VD on the right posterolateral surface was almost entirely occupied by an irregular attached solid mass, with hypoechogenic areas in it. The tumor penetrated into the diverticular wall, interrupting normal reflections. Continuity of the outer limit of the wall was preserved (Stage A-B).Cystoscopy. A large VD was found on the right posterolateral surface with purulent urine and a large solid friable neoformation covered with fibrin, which was biopsied.Histopathology. Grade IV epidermoid carcinoma with perivesical invasion (Stage C) was found.Intravenous Urography (Fig. 1). Ultrasound (Fig. 2). Case I1Intravenous Urography. Multiple small VDs...

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Primary Neoplasms Occurring in Vesical Diverticula: A Report of 18 Cases

Cited by 66 publications

References 9 publications

Diverticular Carcinoma of the Urinary Bladder: Diagnosis and Treatment Problems

Diverticular Carcinoma of the Urinary Bladder: Diagnosis and Treatment Problems

Intradiverticular Tumors of the Bladder: Surgical Implications - An Eleven-Year Review

Carcinomas in vesical diverticula: The role of ultrasound

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