Floyd (71 years old)

Floyd, 71 years old, plays videogames daily hoping to beat his grandson. He underwent cytoscopy which revealed a papillary tumour.  

Assessment summary:

• Pathological review transurethral resection of bladder tumour (TURBT):
  • At least pT2 UCa
  • Unifocal
  • No concomitant carcinoma in situ (CIS)
• Imaging: suggestive for cT2N0M0
• Ultrasound: no hydronephrosis
• Trimodality therapy (TMT):
  • Pathological review second maximal TURBT:
    • pT1 high grade
    • Visually complete resection
    • Muscle in specimen
• Intensity modulated RT on the entire bladder (55 Gy in 20 fractions)
• Concurrent chemotherapy with fluorouracil and mitomycin C

9 months after TMT:

• Imaging: suggestive for a superficial recurrence, cN0M0
• Cystoscopy: papillary tumour
• Pathological review TURBT: pT1 high grade