Extra case 3: Selma (82 years old)

Selma, 82 years old, is a retired farmer who likes watching the seasons change and reminiscing about life on the land.

She presented with episodes of macroscopic haematuria.

Assessment summary:

• ECOG PS: 2
• Medical history: congestive heart failure, obesity
• Cystoscopy:
  • 3 papillary tumours, 1 tumour close to a ureteral orifice
  • Largest tumour diameter: 3.5 cm
• Urine cytology: HG UCa (according to the Paris system)
• Conventional TURBT: resection visually complete, pathological review:
  • pT1 HG
  • Pure UCa
  • No LVI
  • Muscularis propria in specimen, uninvolved
• CT urography: cN0, no concomitant upper tract tumour

She underwent a second TURBT, which revealed no residual papillary tumour.