Image Description
Malignancy in Bladder Diverticula (continued from the previous image): Due to the absence of a well-developed muscularis propria in the diverticulum, pathological staging of invasive malignancies after transurethral resection is difficult and often inaccurate. For e.g. stage pT2 cannot be assigned. There is also a greater risk of transmural spread as well as extravesical extension. Care must be exercised during transurethral resection of these tumors as the diverticular wall is thin and may perforate with resultant tumor seeding into the perivesical fat. The image shows another example of high-grade papillary urothelial carcinoma arising in a bladder diverticulum. The patient was an elderly male with recurrent UTIs. (discussion continues in the next image).