膀胱非尿路上皮性恶性肿瘤的诊断与治疗(附14例报告)

目的：探讨膀胱非尿路上皮性恶性肿瘤的治疗方法和预后。方法：回顾性分析14例膀胱非尿路上皮性恶性肿瘤的临床资料：男、女各7例，年龄34～86岁，平均72．6岁，临床表现主要为无痛性肉眼血尿、尿频、尿急和排尿困难；辅助检查主要为B超、盆腔CT以及膀胱镜检查加活检；行膀胱全切除术9例，膀胱部分切除术1例，经尿道膀胱肿瘤电切除术（TUBRt）4例。结果：术后病理检查证实膀胱腺癌5例，膀胱鳞癌4例，膀胱小细胞癌3例，膀胱平滑肌肉瘤2例；术后平均存活时间为11．3个月，仅1例患者术后39个月仍存活。结论：膀胱非尿路上皮性恶性肿瘤临床少见，恶性程度较高，预后较差。根治性膀胱全切除术是推荐的首选手术方法，结合不同肿瘤类型的病理特点，新辅助或辅助放化疗可以提高疗效。     

膀胱腺癌的诊断与处理(附41例报告)

目的　提高膀胱腺癌的诊断与治疗水平。　方法　分析经手术病理证实的 4 1例膀胱腺癌患者资料。原发性膀胱腺癌 18例 ,作全膀胱切除 尿流改道 8例 ,膀胱部分切除 10例 ;脐尿管腺癌 12例中扩大膀胱部分切除 11例 ;转移性腺癌 11例均切除膀胱病灶。　结果　膀胱腺癌占同期膀胱癌的 3.2 %。 37例随访 5个月～ 10年 ,1年生存 19例 (5 1.3% ) ,2年生存 16例 (43.2 % ) ,5年生存 8例 (2 1.6 % )。　结论　原发性膀胱腺癌宜行根治性全膀胱切除术 ,脐尿管腺癌应作扩大性膀胱部分切除 ,对复发、转移性患者应采用综合治疗 ,以提高生存率     

恶性嗜铬细胞瘤(附12例报告)

目的提高恶性嗜铬细胞瘤诊治水平.方法总结12例恶性嗜铬细胞瘤患者临床资料.结果12例均行手术治疗,1例术后24h死于顽固性低血压,余11例随诊2年6个月～13年,平均5年6个月.首次手术根据肿瘤浸润及局部淋巴结转移情况确诊恶性嗜铬细胞瘤5例中,1例膀胱恶性嗜铬细胞瘤行膀胱部分切除术后,出现顽固性低血压,抢救无效于术后24h死亡;余4例存活2～3年死于肿瘤复发及高血压并发症.7例首次手术病理诊断为嗜铬细胞瘤者,术后10个月～5年肿瘤复发,病程中发现肿瘤转移至肝3例,肝、肺、骨均有转移者2例,局部淋巴结转移2例.存活时间<2年者3例,3～11年者4例(包括目前存活3例).结论病理难以区别肿瘤的良恶性,现代影像学检查(CT、MRI等)可为恶性嗜铬细胞瘤的诊断提供参考依据.对直径>5cm,内部结构不均匀的复发性嗜铬细胞瘤,应果断行根治性肿瘤切除术.     

食管非鳞癌恶性肿瘤及外科治疗

目的:探讨食管癌高发区食管非鳞状细胞恶性肿瘤的发病状况、病理特点及外科治疗。方法:对1992～1998年外科治疗89例食管非鳞癌恶性肿瘤的临床病理资料进行总结分析。结果:非鳞癌性食管恶性肿瘤占食管恶性肿瘤发病的4.1％,其中腺癌占非鳞癌食管恶性肿瘤的61.8％,小细胞癌占29.2％,食管癌肉瘤占5.6％,恶性纤维组织细胞瘤占2.2％,横纹肌肉瘤占1.1％。手术切除率92.1％,生存率分别为:腺癌1年70.0％,3年30.0％,5年17.8％;小细胞癌1年45.8％,3年25.0％,5年8.7％;癌肉瘤3年80.0％,5年60.0％;肉瘤3年100.0％,5年66.7％。结论:食管腺癌发病无地区性,食管癌高发区食管腺癌与西方食管腺癌组织来源不同;食管小细胞癌恶性程度极高,易外侵及发生远处转移;癌肉瘤和其他类型肉瘤在食管恶性肿瘤中发病罕见。腺癌、小细胞临床表现与食管鳞癌基本相同,小细胞癌应行手术+化疗的综合治疗,腺癌及其它类型肿瘤的治疗,手术为首选方法。     

脐尿管癌的临床病理学特点及手术疗效观察

目的 探讨脐尿管癌的临床病理学特点,提高诊疗水平. 方法脐尿管癌患者7例.男6例,女1例.平均年龄52(26～75)岁.临床表现间歇无痛肉眼血尿5例,血尿伴尿中有黏液1例,血尿伴下腹部疼痛1例.术前检查包括彩色多普勒超声、膀胱镜、尿脱落细胞、CT、IVU.肿瘤直径平均3.6(2.0～6.0)cm.7例中行扩大性膀胱部分切除6例,行膀胱部分切除术1例. 结果 病理报告黏液腺癌5例,肿瘤细胞呈柱状,胞质内见空泡状黏液分泌特征;未特殊分类腺癌1例,癌细胞呈腺样排列,腺腔大小不等,形态不规则,癌细胞核大,染色质深;小细胞型内分泌癌1例,癌组织主要位于肌层及脂肪组织中,呈片状分布,癌细胞核小呈短梭形或圆形,可见空心菊形团结构,免疫组化神经元特异性烯醇化酶阳性.Sheldon分期ⅢA期6例,ⅢC期1例.1例术后3个月死于多发骨转移,1例术后15个月和2年分别出现膀胱颈部及尿道复发接受经尿道肿瘤电切术,余5例随访2～30个月,肿瘤无复发. 结论脐尿管癌是一种少见类型的恶性肿瘤,预后差,早期扩大性膀胱部分切除术可以达到长期无瘤生存效果,脐尿管下端体积较小的肿瘤可行保留脐部手术,放化疗无肯定疗效.     

改良乙状结肠原位膀胱术(附7例报告)

根治性全膀胱切除术是治疗浸润性膀胱移行细胞癌最有效的手段。膀胱全切后尿路重建或尿流改道直接关系到患者术后生活质量。 2 0 0 0年 1月～ 2 0 0 1年 6月我们行根治性膀胱切除术治疗膀胱移行细胞癌 2 2例 ,对其中 7例作改良乙状结肠替代原位膀胱尿路重建术 ,获得了较理想的结果 ,报告如下。1　资料与方法1 .1 　 临床资料7例男性患者 ,年龄 46～ 5 6岁 ,平均 5 0 .1岁。均为浸润性膀胱移行细胞癌 ,术前肿瘤临床分期Ｔ2ａ～2ｂ Ｎ0 Ｍ0 ,细胞分级Ⅱ级 3例 ,Ⅲ级 4例。1 .2 　 手术方法气管内全麻 ,下腹正中切口 ,将脐尿管残迹连同该部腹膜…     

肾上腺恶性肿瘤(附50例报告)

目的 提高肾上腺恶性肿瘤的诊治水平。方法 回顾性分析50例肾上腺恶性肿瘤的临床资料。其中有功能肾上腺皮质癌7例，均有相关临床表现和内分泌异常；恶性嗜铬细胞瘤23例，表现高血压19例，24h尿儿茶酚胺增高18例；无功能肾上腺皮质癌15例；肾上腺转移癌5例。患者术前均行内分泌和影像学检查。结果 27例肾上腺皮质癌和转移癌中25例由病理确诊，2例于随访中得以确诊。23例恶性嗜铬细胞瘤中ll例根据影像学和手术探查发现广泛浸润或转移灶确诊，12例于随访期间发现转移灶确诊。14例肾上腺皮质癌获肿瘤切除，8例存活1-5年；12例恶性嗜铬细胞瘤获肿瘤切除，生存1-14年。结论 绝大多数肾上腺皮质癌可根据病理或有远处转移的影像学检查定性。嗜铬细胞瘤复发，尤其是肾上腺外嗜铬细胞瘤复发恶性可能性极大，但恶性嗜铬细胞瘤必需要有影像学或病理证实肿瘤浸润或扩散到无副神经节的组织中才能确诊。晚期肾上腺皮质癌预后差，晚期恶性嗜铬细胞瘤用苯苄胺及131I-MIBG治疗可明显延长生存期。     

嗜铬细胞瘤与同侧肾细胞癌(附二例报告及文献复习)

目的　探讨嗜铬细胞瘤与肾细胞癌的关系 ,提高对嗜铬细胞瘤与同侧肾细胞癌并存的认识及诊治水平。　方法　报告 2例嗜铬细胞瘤与同侧肾细胞癌并存患者诊治资料。　结果　 1例左肾上腺嗜铬细胞瘤者术前误诊为左肾转移癌 ,行同侧肾上腺切除的肾癌根治术 ,术中发生危象 ,经抢救治愈。 1例术前确诊为右肾上腺嗜铬细胞瘤并同侧肾癌者手术顺利。　结论　一侧肾癌并同侧肾上腺嗜铬细胞瘤临床罕见 ,应提高对“静止型嗜铬细胞瘤”的认识 ,手术治疗应有充分的围手术期准备     

嗜铬细胞瘤与同侧肾细胞瘤（附二例报告及文献复习）

目的 探讨嗜铬细胞瘤与肾细胞癌的关系,提高对嗜铬细胞瘤与同侧肾细胞癌并存在认识及诊治水平。方法 报告２例嗜铬细胞瘤与同侧肾细胞癌并存患者诊治资料。结果 １例左肾上腺嗜铬细胞瘤者术前误诊为左肾转移癌,行同侧肾上腺切除的肾癌根治术,术中发生危象,经抢救治愈,１例术前确诊为右肾上腺嗜铬细胞瘤并用侧肾癌者手术顺利。结论 一侧肾癌并同侧肾上腺嗜铬细胞瘤临床罕见,应提高对“静止型嗜铬细胞瘤”的认识,手术治疗应有充分的围手术期准备。     

安德逊癌症中心多种方法治疗脐尿管癌的经验

脐尿管癌是一种少见的腺癌 ,常发生于脐尿管韧带和膀胱顶部连接处 ,占膀胱肿瘤不足 1%。为了提高对脐尿管癌的认识并了解目前治疗方法的疗效 ,作者回顾性分析了 1985年至 2 0 0 1年间安德逊癌症中心诊治的 42例脐尿管癌患者资料 ,并评估了病变范围、外科特征和系统治疗对临床预后的重要性。 42例患者中 7例在诊断时已经出现转移 ,另 3 5例接受手术治疗 ,平均生存时间46个月 ,40 %的患者生存超过 5年。接受手术切除的患者 16例 (46% )保持无瘤状态 (平均随访 3 1个月 ) ,其余 19例最终出现转移。与长期生存相关的因素为外科切缘阴性 (P =0 .…     

原发性膀胱小细胞癌诊治体会

目的 探讨膀胱小细胞癌的临床及病理特点.方法 回顾性分析9例膀胱小细胞癌的基本资料.男6例,女3例.年龄45～79岁,平均62岁.临床表现为肉眼血尿7例,排尿困难及下腹部疼痛2例.肿瘤直径0.5～7.0 cm,平均2.0 cm;多发2例,单发5例,全膀胱弥漫性生长2例.7例行尿脱落细胞学检查,阳性4例.9例均行手术治疗,其中4例术前诊断为浅表性者行TURBt,术后均定期行吡柔比星膀胱灌注,1例化疗3个周期;膀胱部分切除2例,均定期行吡柔比星膀胱灌注,1例化疗2个周期;根治性膀胱全切3例,静脉化疗2例.结果 术后病理检查:肿瘤细胞体积小,呈圆形,胞质稀少,核浓染,缺乏巢状结构.免疫组化染色:嗜铬素A(+)、神经元特异性烯醇化酶(+).诊断为小细胞癌,其中1例含移行细胞癌成分,1例合并前列腺癌.1例术前检查显示高血钙(3.15 mmol/L)和低血磷(0.61 mmol/L),术后1个月血钙及血磷恢复正常.保留膀胱者随访4例,3例分别于术后4、9、25个月死于转移,1例术后化疗者随访24个月未见复发及转移.膀胱全切3例中2例分别于术后2、28个月死亡,1例术后随访32个月未见肿瘤复发及转移.结论膀胱小细胞癌恶性程度高,预后差,根治性膀胱全切加全身化疗是主要的治疗方法,保留膀胱的手术应配合全身化疗.决定预后的是肿瘤的临床分期及治疗方法.

Abstract：

Objective To investigate the clinical and pathological features of small cell carcinoma of the urinary bladder. Methods The pathological and clinical data of 9 cases of small cell carcinoma were analyzed retrospectively. There were 6 males and 3 females, ages 45 to 79 years (mean age, 62 years). Clinical manifestations of 7 cases included gross hematuria and dysuria, the other 2 cases experienced lower abdominal pain. The mean tumor size was 2.0 cm (ranged, 0.5 to 7.0 cm). Two cases had multiple tumors and 5 cases had single tumors. The growth pattern in 2 cases was diffuse growth in the whole bladder. In 4 cases tumor cells were found in urine cytology. All 9 patients underwent surgical treatment, including TURBt. Four patients were diagnosed as superficial tumors before operation. All the patients underwent regular theprubicine irrigation in the bladder. One case underwent additional intravenous chemotherapy for 3 cycles. Partial cystectomy was performed in 2 cases, with regular theprubicine irrigation in bladder and 1 case underwent intravenous chemotherapy for 2 cycles. Radical cystectomy was performed in 3 cases, with 2 cases undergoing intravenous chemotherapy after operation. Results Pathological findings showed that tumor cells were small and round in shape. These hyperchromatic nuclei showed limited cytoplasm with lack of nesting characters. CgA and NSE were positive in immunohistochemistry. The final diagnosis was small cell carcinoma, with 1 case accompanied with transitional cell carcinoma and 1 case accompanied with prostate cancer. One case showed high preoperative serum calcium (3.15 mmol/L) and low serum phosphate (0.61 mmol/L), which returned to normal 1 month after operation. Four cases who′s bladder was preserved were followed up, 3 cases were alive for 4, 9 and 25 months after operation. The 1 case who underwent intravenous chemotherapy was followed up for 24 months and there was no sign of relapse or metastasis. In all the 3 cases with radical cystectomy, 2 cases died 2 and 28 months postoperativly. Another case with adjuvant chemotherapy was followed up for 24 months without recurrence or metastasis. Conclusions Small cell carcinoma of the urinary bladder is highly malignant with poor prognosis. Radical cystectomy in combination with systemic chemotherapy has better efficacy. Retained bladder surgery with systemic chemotherapy is an alternative choice. The most important factors which influence the prognosis of the tumor are clinical stage and therapeutic methods.     

非小细胞肺癌术后支气管切缘癌与预后

为探讨肺癌术后支气管切缘癌的发生率及预后特点，提高肺癌５年生存率，回顾总结１９８１～１９９０年经手术治疗１０２４例非小细胞肺癌，显微镜下发现支气管残端癌阳性者８９例占８．７％。此８９例病人平均５年生存率２３．７％。中位数生存期２７．６个月。其中ＰＴＮＭＩ、ＩＩ、ＩＩａ和ＩＩｂ期病人平均生存期分别为４４．３、２７．１、１２．４和１２．６个月，鳞癌、腺癌、大细胞癌及鳞腺混合癌病人的平均生存期分别为３１．０、１９．３、１４．８和２８．３个月。结论：影响病人预后的因素主要是病变的ＴＮＭ分期及细胞类型，对有残端癌的病人应强调术后综合治疗     

Clinical outcomes following radical cystectomy for primary nontransitional cell carcinoma of the bladder compared to transitional cell carcinoma of the bladder

PURPOSE: The effect of bladder cancer histological subtypes other than transitional cell carcinoma (nonTCC) on clinical outcomes remains uncertain. We conducted a multi-institutional retrospective study of patients with bladder cancer treated with radical cystectomy to assess the impact of nonTCC histology on bladder cancer specific outcomes. MATERIALS AND METHODS: A total of 955 consecutive patients underwent radical cystectomy with bilateral pelvic lymphadenectomy for bladder cancer at 3 academic institutions. TCC was present in the radical cystectomy specimen in 888 patients (93%). NonTCC histology was present in 67 patients (7%), including squamous cell carcinoma in 26, adenocarcinoma in 13, small cell carcinoma in 10 and other nonTCC subtypes (ie spindle cell carcinoma, carcinosarcoma and undifferentiated carcinoma) in 18. For patients alive at last followup median followup was 39 and 23 months for patients with TCC and nonTCC histologies, respectively. Bladder cancer specific progression and survival were assessed using Kaplan-Meier and multivariate Cox proportional hazards analyses. RESULTS: Bladder cancer specific progression and mortality did not differ significantly between patients with SCC and TCC histologies. Patients with nonTCC and nonSCC bladder cancer were at significantly increased risk for progression and death compared to patients with TCC or SCC (p <0.001). This association remained statistically significant in patients with organ confined disease (stage pT2 or lower) and patients with nonorgan confined disease (stage pT3 or higher) (p <0.001). In a multivariate analysis nonTCC and nonSCC histology was associated with an increased risk of bladder cancer progression and death (OR 2.272 and 2.585, respectively, p <0.001), even after adjusting for final pathological stage, lymph node status, lymphovascular invasion and neoadjuvant or adjuvant treatments. CONCLUSIONS: NonTCC and nonSCC histological subtype is an independent predictor of bladder cancer progression and mortality in patients undergoing radical cystectomy for bladder cancer. Patients with bladder TCC and SCC share similar stage specific clinical outcomes.     

膀胱前列腺共存肿瘤的诊断和治疗（附14例报告）

目的：提高对膀胱前列腺共存肿瘤的诊断与治疗水平。方法：结合文献回顾性分析14例膀胱前列腺共存肿瘤患者的临床和病理资料。结果：以膀胱肿瘤首诊11例,术前均经膀胱镜活检病理证实为膀胱移行细胞癌（9例）、鳞癌（2例）,该组有3例行经直肠前列腺穿刺活检,结果2例为前列腺癌,1例为前列腺增生症,该例与余8例行膀胱前列腺切除或TURBT＋TURP后病理证实为前列腺癌。术后随访6～37个月。1例术后23个月死于心梗;1例术后10个月死于全身广泛转移和并发症;1例失访;8例无瘤生存。以前列腺肿瘤首诊3例分别行膀胱部分切除术＋双睾丸切除术、前列腺癌根治术＋TURBT、姑息性输尿管皮肤造瘘术,随访42、16、25个月,2例术后死于多发性转移,1例无瘤生存。结论：膀胱前列腺共存肿瘤是较少见的一种多原发肿瘤,临床上易漏诊。直肠指检、经直肠B超、PsA测定、活检和膀胱镜检的综合应用是目前诊断膀胱前列腺共存肿瘤的主要方法。两者共存并不提示预后不良。     

膀胱内翻性乳头状瘤的诊治

目的：探讨膀胱内翻性乳头状瘤的临床特点、病因、病理和诊断治疗。方法：回顾性分析50例膀胱内翻性乳头状瘤的临床资料,复习相关文献,并随访患者。结果：所有患者均接受经尿道膀胱肿瘤电切术（TURBT）治疗;术后病理证实均为膀胱内翻性乳头状瘤,其中29例合并膀胱移行细胞癌;术后42例行膀胱灌注治疗,随访3个月～5年,1例患者肿瘤复发。结论：膀胱内翻性乳头状瘤是泌尿系少见的良性肿瘤,易合并移行细胞癌,很少复发,预后良好。确诊需行内镜检查及活检。TURBT是其标准治疗方法。术后予膀胱灌注有利于防治复发。     

非血吸虫性膀胱鳞状细胞癌诊疗和预后分析(附21例报告)

目的:探讨非血吸虫性膀胱鳞状细胞癌的病因、诊断、治疗及预后情况。方法:回顾分析21例经术后病理检查证实为膀胱鳞癌患者的临床资料,包括其临床症状、检查、治疗及预后情况,对其预后情况进行相关的统计分析。结果:21患者中主要症状表现为血尿、膀胱刺激症状、泌尿系感染等。患者1年、2年及5年生存率分别为55%、30%和5%,中位生存期16.1个月。初次就诊时T1期0例,4例发现盆腔淋巴结转移,1例发现肺部转移。接受根治性膀胱全切的患者生存期明显长于未行根治性膀胱全切的患者。随着T分期的增高,患者生存期逐渐减短;盆腔淋巴结转移的4例患者分别于术后8、10、11、18个月死亡,而未发现淋巴结转移的患者中有6例存活至少2年或以上,最长者目前随访75个月仍生存;不同肿瘤分级患者生存期无明显差异。部分患者接受放化疗等辅助治疗,但对患者预后改善不明显。结论:膀胱鳞癌预后差,早期诊断很重要,应尽早行根治性膀胱全切+盆腔淋巴结清扫术以改善患者预后,放化疗在膀胱鳞癌治疗中的作用仍需进一步探讨。     

膀胱小细胞癌3例

目的 探讨膀胱小细胞癌的临床病理特征和诊治方法。方法 总结3例膀胱小细胞癌患者资料,结合文献复习讨论。结果 1例行膀胱部分切除术,术后4月复发转移7月死亡。1例行髂内动脉插管化疗,至今带瘤生存14月。另1例行膀胱部分切除术,术后6月无复发转移,至今健在。病理学检查肿瘤细胞较小,核浓染,胞浆稀少,核仁不显著,核分裂相多见。免疫组化NSE3例均阳性。结论 膀胱小细胞癌临床罕见,诊断主要依靠病理学检查,此病预后差,应提倡手术切除辅以放疗及全身联合化疗。     

膀胱小细胞癌的病理组织学特点及其诊治

目的:探讨膀胱小细胞癌病理组织学特点及其诊断与治疗。方法:回顾分析6例膀胱小细胞癌患者的临床和病理资料,6例患者行经尿道膀胱肿瘤电切术2例,膀胱部分切除术1例,行膀胱全切术2例,单纯化疗1例。5例患者接受2～6疗程化疗。结果:6例随访3个月～3年,1例患者术后生存2年至今,5例均因肿瘤转移死亡,平均生存时间14.8个月。结论:膀胱小细胞癌分化程度低、恶性程度高、易早期转移、预后差,主要依靠病理组织学检查确诊,现有治疗方法不足以将其治愈,手术联合化疗是目前主要的治疗方法,分子靶向治疗是未来治疗的主要手段。     

Malignant non-urothelial neoplasms of the urinary bladder: a review

OBJECTIVES: Non-urothelial bladder tumors frequently present a diagnostic and therapeutic challenge. We review the peer-reviewed literature to summarize the available evidence on the etiology, diagnosis and optimal management of malignant non-urothelial bladder tumors. METHODS: A comprehensive MEDLINE database search was performed. In addition, the proceedings of recent national and international urological and cancer society meetings were reviewed. RESULTS: Primary non-urothelial bladder tumors are rare in Europe and North America representing less than 5% of all bladder lesions combined. A large number of risk factors have been implicated in the etiology of non-schistosomiasis-related squamous cell carcinoma, yet their exact pathomechanism remains poorly defined. Squamous cell carcinoma, adenocarcinoma, small cell carcinoma, sarcoma and carcinosarcoma/sarcomatoid tumors share an unfavorable prognosis despite aggressive surgical management that relates both to an aggressive biological behaviour as well as to an often times advanced stage at the time of diagnosis. Inflammatory pseudotumors are benign tumors of uncertain histogenesis that may mimic sarcomas. Paraganglioma, primary melanoma and lymphoma represent additional, exceedingly rare bladder tumors. CONCLUSIONS: The systematic investigation of most non-urothelial bladder tumors is limited by the rarity of these lesions. A concerted effort of multiple institutions linked together in a national or international tumor registry will be necessary to advance our understanding of these tumors, evaluate treatment strategies and optimize patient outcome in the future.     

Bladder cancer in Sri Lanka: Experience from a tertiary referral center

BACKGROUND: Bladder cancer is one of the most common malignancies occurring worldwide. No published data exists on bladder cancer in Sri Lanka. The objective of the study was to determine the clinicopathological characteristics of histologically confirmed transitional cell carcinoma (TCC) of the bladder in Sri Lanka. METHODS: Three hundred and one patients were diagnosed with primary bladder cancer during a 7.5-year period from 1993 to 2000. Two hundred and eighty-one patients (239 men and 42 women; mean age, 66 years; range, 26-88) with TCC of the bladder were evaluated with regard to clinical presentation, cystoscopic findings and histopathological data. RESULTS: Transitional cell carcinoma accounted for 93.4% of primary bladder cancer. There was a male predominance with a sex ratio of 6:1. The majority of patients (63.7%) were in the 7th and 8th decades of life. Painless hematuria was the most common presenting symptom (52.7%), followed by painful hematuria (39.2%). The median duration of hematuria for all TCC patients, as well as for muscle-invasive TCC patients, was 3 months. Papillary configuration at cystoscopy, was found in 89.7% of non-invasive urothelial tumors. In contrast, 77.8% of invasive TCC patients had a solid/mixed tumor configuration. One hundred and forty-five patients (51.6% of TCC) had non-invasive urothelial tumor and 136 patients (48.4%) had muscle-invasive disease. In the non-invasive urothelial tumor category, 61 patients (42.0%) had pTa tumors and 84 patients (58.0%) had pT1 tumors. Of newly diagnosed TCC cases, 5.3% were found to be T1G3 urothelial carcinomas. Fifty-six patients (38.6%) with non-invasive urothelial tumor had a tumor greater than 5 cm in size. CONCLUSIONS: More than 90% of primary bladder tumors in Sri Lanka are TCC, with nearly half the patients having muscle-invasive diseases on initial presentation. Even in non-invasive urothelial tumors, the majority (58.0%) have lamina propria invasion.