Reflections on bladder neoplasia. Exophytic papillary urothelial tumors versus planophytic carcinoma in situ.

Exophytic (papillary) urotheliomas often occur concomitantly or sequentially with the planophytic carcinomas in situ. The natural history of the two types differs: the former initially shows cell uniformity, orderly arrangement of cell layers, and an adequate vascular supply whose branchings penetrate centrally into the fronds. They tend to respond favorably to any of the present-day modalities of treatment (excision, fulguration, thiotepa, etc).

The role of urine in a patient with a bladder neoplasm.

A review was done on reported cases of spontaneous regression of superficial bladder tumors in which cystectomy was preceded by bilateral ureterosigmoidostomy (the interval ranging from 21 days to 6 months). In every case in which the tumors were superficial complete disappearance of the papillary masses was observed by the naked eye and by microscopic examination. Tumor cells persisted in those cases in which the bladder wall was involved.