R. Giovannone

Recurrent transitional cell carcinoma of the bladder: A mixed nested variant case report and literature review

Nested variant of urothelial cell carcinoma (NVUC) is a rare histological entity, with about 80 reported cases. It has a deceptively benign appearance with an aspect characterized by confluent small nest or urothelials cell tubules. This tumour often resembles inverted papilloma, von Brunns nests (VBNs), cystitis cystica, nephrogenic metaplasia and sometimes usual transitional cell cancer. It is very important to be able to distinguish between benign lesions and nested variant bladder cancer because, in spite of its bland morphology, there is evidence that it behaves aggressively.

Short‐term pretreatment with a dual 5α‐reductase inhibitor before bipolar transurethral resection of the prostate (B‐TURP): evaluation of prostate vascularity and decreased surgical blood loss in large prostates

To investigate if short‐term treatment with dutasteride (8 weeks) before bipolar transurethral resection of the prostate (B‐TURP) can reduce intraoperative bleeding, as dutasteride a dual 5α‐reductase inhibitor (5‐ARI) blocks the conversion of testosterone into its active form dihydrotestosterone (DHT), and reduces prostate volume and prostate‐specific antigen (PSA) levels, while increasing urinary flow rate.

Primary Metastatic Neuroendocrine Small Cell Bladder Cancer: A Case Report and Literature Review

Small cell carcinoma of the urinary bladder (SCCUB) is a rare variant of neuroendocrine nonepithelial tumor. Clinically, SCCUB appears like a flat or ulcerated lesion and microscopically can cause microvascular invasion and necrosis. Small cell cancer, rarely found in the urogenital tract in a primitive form, usually coexists with urothelial bladder cancers. It has an incidence of 0.35–0.7% of all bladder neoplasms and survival at 5 years is estimated to be around 8%. A 60-year-old man who was a smoker was referred to our department with episodes of gross hematuria and pain in the lumbar region. After an extensive transurethral resection of the bladder, including of the muscular layer, the diagnosis of small cell carcinoma of the bladder was made. The neoplastic cells were positive with immunohistochemical staining for chromogranin A, paranuclear reactivity to cytokeratin and neuron-specific enolase. A total-body CT scan revealed lymph node involvement and hepatic, adrenal and lung metastases. Because of the advanced stage it was decided to avoid radical cystectomy and perform chemotherapy. The patient underwent two different cycles of cisplatin chemotherapy following international recommendations, but unfortunately without any response. After palliative therapy, the patient died in January 2010.