Bladder cancer
Management of BCG-pretreated (very) high-risk NMIBCHiram (68 years old)
Hiram is a 68-year-old retired veterinarian who enjoys playing the harmonica. He presented with episodes of macroscopic haematuria.
Assessment summary:
- Medical history: obesity, diabetes mellitus type 2
- ECOG PS: 1
- Cystoscopy: papillary tumour of 2 cm at the right bladder wall, multiple reddish lesions
- Urine cytology: HG UCa (according to the Paris system)
- Conventional TURBT: resection visually complete, pathological review:
- pT1 HG + CIS
- Pure UCa
- No LVI
- Muscle in specimen
- Second TURBT: CIS
- CT urography: cN0, no concomitant upper tract tumour
BCG induction was started. Follow-up cystoscopy at 3 months (i.e., BCG induction completed) shows a 1 cm papillary tumour. Conventional TURBT confirms pTa low-grade (muscle in specimen, no LVI).