Background: The transitional cell carcinoma within the bladder diverticular is a rare and poorly known entity.

Aim: To evaluate diagnostic and therapeutic approaches of transitional cell carcinoma within the bladder diverticular.

Methods: Thirty men and two women (median: 70 years; 44- 83 years) were included. The main reason for consultation was hematuria. The intra-diverticular tumor was suspected by radiological assessment in 9 patients only. All these patients underwent an endoscopic resection of the tumor.

Results: The histological study concluded to a pta stage in 16 patients, pt1 stage in 8 patients and invasive tumors in 8 patients. A complementary endovesical BCG-therapy was performed in patients with superficial tumors and a radical cystectomy in patients with invasive tumors. With an average follow-up of 27 months, seven recurrences were found in the group of superficial tumors, including 3 cases of progression to invasive stage.

Conclusion: Bladder intra-diverticular tumors are rare and more common in elderly. In a bladder diverticulum, there are superficial tumors (pta, pt1) which are the most frequent and invasive tumors. Radical cystectomy is the gold standard for invasive tumors.Endoscopic resection combined with endo-vesical immunotherapy should be reserved for superficial tumors.

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