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Herniation of bladder mucosa through the bladder wall muscle layer is known as bladder diverticulum. The incidence of bladder diverticulum is 1.7. About 0.8 to 10% of the urinary bladder diverticulum develops carcinoma. Transitional cell carcinoma is the most common. Painless hematuria is the most common clinical presentation. Different imaging mod...
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Background
Nowadays, lymphadenectomy could be performed by the transperitoneal or extraperitoneal approach. Nevertheless, each approach has its own advantages and disadvantages. Under these circumstances, we developed a transumbilical laparoendoscopic single-site (TU-LESS) extraperitoneal approach for lymphadenectomy. In this research, the primary...
Purpose:
To analyze the results of patients treated with perioperative interstitial brachytherapy (ISBT) in tongue carcinoma (TC).
Material and methods:
From April 2009 to May 2015, 43 squamous cell carcinoma consecutive patients diagnosed with TC were treated with limited partial glossectomy and perioperative ISBT, using high-dose-rate (HDR). T...
(1) Background: This population-based study aimed at identifying the factors associated with the likelihood of detection of stage IA cervical carcinoma—versus the detection of stage IB through IV cervical carcinoma—and the patterns of surgical treatment. (2) Methods: Between 1995–2016, 3750 patients living in the Emilia-Romagna Region (northern Ita...
Citations
... One study found that 84% patients who underwent elective diverticulectomy for bladder diverticula exhibited mucosal inflammation, ulceration, dysplasia, squamous metaplasia, and leukoplakia [39]. Other investigators have suggested that chronic exposure to carcinogens and human papillomavirus (HPV) infection may contribute to neoplastic changes within a bladder diverticulum [40]. According to a review by Walker et al., urothelial carcinoma accounts for the majority of IDBT (72%), followed by small cell carcinoma (8.3%), urothelial carcinoma with squamous differentiation (5.6%), pure squamous cell carcinoma (5.6%), sarcoma (5.6%), and adenocarcinoma (2.8%) [16]. ...
Urinary bladder diverticula are common and are frequently incidentally discovered. Many downstream complications can occur due to urinary stasis, such as bladder diverticular stones, infection, and malignancy. Understanding the physiology of bladder diverticula and potential pitfalls and mimics is critical to an accurate description of bladder diverticula and early detection of potential downstream complications. This pictorial review will first review the normal bladder histology and function, bladder diverticular types, and typical imaging features. The paper will then draw attention to technical pitfalls and potential mimics. Finally, we will review the downstream complications, including stones, infection, malignancy, and BCG-related changes.
Graphical abstract
... Bladder diverticular carcinoma is a rare malignant tumor originating in the bladder, accounting for approximately 0.8% to 10% of all bladder malignancies in clinical practice [1]. Due to the characteristics of the bladder diverticulum, such as a relatively weak muscular layer, underdevelopment, or even absence of the muscle layer, tumors within the diverticulum are more prone to invasion or metastasis. ...
Objective To investigate the safety and efficacy of laparoscopic partial cystectomy in the treatment of bladder diverticulum cancer. Methods A retrospective analysis was conducted on the clinical data of 12 patients with bladder diverticulum cancer treated at the First Affiliated Hospital of Quanzhou, Fujian Medical University, from January 2016 to May 2023. All patients underwent laparoscopic partial cystectomy. The study evaluated surgical details, pathological results, postoperative complications, adjuvant treatments, and follow-up outcomes. Results All 12 patients successfully underwent laparoscopic partial cystectomy with no significant intraoperative complications. Postoperative pathological results confirmed urothelial carcinoma in all cases. After surgery, all patients received bladder instillation therapy, with 5 undergoing systemic intravenous chemotherapy and 1 receiving intra-arterial chemotherapy to further prevent tumor recurrence. During the follow-up period, which ranged from 16 to 49 months, 11 patients had no tumor recurrence, while 1 patient experienced recurrence 15 months after surgery. Conclusion Laparoscopic partial cystectomy is a safe and effective treatment for bladder diverticulum cancer, with minimal postoperative complications and good tumor control outcomes.
... Partial cystectomy in combination with pelvic lymphadenectomy, followed by adjuvant treatment, is recommended in patients with high-grade tumors and without associated carcinoma in situ [ 2 ,9 ]. Radical cystectomy is a selected procedure for patients with high-grade, locally advanced IBDT with multifocal exophytic neoplasms within the bladder, associated carcinoma in situ, or multifocal disease in combination with unsatisfactory bladder function [9] . ...
Bladder diverticula are defined as an outpouching of the mucosa into the muscle layer of the bladder wall. There is a well-known link between urinary bladder diverticula and tumors arising within the diverticula. They are rare with an incidence rate of 0.8%-10%. We report an intradiverticular urothelial carcinoma in a 72-year-old man with a known history of multiple episodes of acute urinary retention and urinary tract infections, followed by transurethral resection of the benign prostatic hyperplasia.
Intradiverticular transitional cell carcinoma (TCC) of the bladder poses unique challenges due to its presentation within the bladder diverticula. This review synthesizes current knowledge on the diagnosis and management of this condition, emphasizing the need for early detection to optimize patient outcomes. The literature underscores the importance of tailored treatment strategies, ranging from radical surgeries to adjuvant chemotherapy, to combat the aggressive nature of intradiverticular TCC. Additionally, stringent post-treatment surveillance protocols are vital in addressing high recurrence rates. Future research directions include biomarker identification, comparative efficacy studies of treatment modalities, and the exploration of innovative therapeutic approaches such as immunotherapy. Longitudinal studies analyzing patient outcomes will provide valuable insights into survival rates and quality of life post-treatment, informing future clinical guidelines. This comprehensive review aims to enhance understanding and management strategies for intradiverticular TCC, paving the way for improved patient care and outcomes in this challenging form of bladder cancer.
Objective: Intradiverticular bladder tumors (IDBT) are uncommon clinical entities. We reviewed the literature for clinical presentation, diagnosis and therapeutic options to establish recommendations for diagnostic and therapeutic management.
Methods: Bibliographic research was performed using PubMed from database inception until October 15, 2022. A pooled analysis was performed of 498 patients with IDBT presented in the literature. The evaluation included patient sex, age, diagnostic methods, symptoms, localization of the tumor, tumor staging, tumor histopathology, treatment, and the presence of recurrence. To express results, descriptive statistics were used appropriately.
Results: The mean age at diagnosis was 64.81 years (range 49 days to 84 years). The ratio between men and women was ≈ 24:1, suggesting a male predominance (85% male, 3.6% female). The most common presenting symptom was gross hematuria (60.88%). Most of the patients had cystoscopy (56.85%) and intravenous or computed tomography urography (52.01%). Regarding tumor staging, most of the patients were diagnosed with pT1 tumors. For the histopathology of IDBT, 87.95% of the specimens were transitional cell carcinomas and in 10.84% there were concomitant CIS. Regarding the treatment, radical cystectomy was chosen in 34.34%, partial cystectomy in 26.66%, diverticulectomy in 15.95% and transurethral resection of bladder tumour (TURBT) in 16.36% of the patients.
Conclusions: Most common diagnostic tool for IDBT seems to be cystoscopy followed by computerized tomography urogram. Due to the absence of muscle layer in the diverticulum and the highgrade histology of most of them at diagnosis, cystectomy is the first therapeutic choice. However, for patients that are not considered appropriate candidates or for those presenting with lowgrade and low volume tumors, TURBT is a good option.
