Mireille (77 years old)

Mireille, a 77-year-old former librarian who enjoys bookbinding, is suspected of having bladder cancer.

Assessment summary:

• No relevant medical history
• ECOG PS: 0
• Cystoscopy: papillary tumour of 4.5 cm at the right bladder wall
• Urine cytology: negative for HG UCa (according to the Paris system)
• Conventional TURBT: resection visually complete, pathological review:
  • pT1 HG
  • Pure UCa
  • No LVI
  • Muscle in specimen
• Second TURBT: no residual disease
• CT urography: cN0, no concomitant upper tract tumour

BCG induction was started and followed by maintenance BCG. 9 months after start of BCG therapy (i.e. BCG induction and 2 courses of BCG maintenance completed), the patient presents with a papillary tumour of 1 cm near the previous resection side. Conventional TURBT confirms pTa HG (muscle in specimen, no LVI).