Squamous cell carcinoma of the bladder. Review of our case series

OBJECTIVES: The squamous cell carcinoma of the bladder is a rare tumor in our environment, representing between 1.6-6.7% of all bladder neoplasias. It is more common to find foci of squamous differentiation associated with a transitional cell carcinoma. METHODS: We retrospectively review all squamous cell carcinomas diagnosed and treated in our hospital between 1994 and 2004. We analyze their biological behaviour and the treatment applied. RESULTS: We found 11 cases of squamous cell carcinoma of the bladder, which pathologically were pure squamous cell carcinomas in eight patients and mixed in another three. Mean patient age was 70.9 years ranging from 49 to 88 years, six of them were males and five females. All of them presented locally advanced tumor stages at the time of diagnosis (> or = T2). Although the treatment of choice is radical cystectomy, it could only be applied in three patients; it was associated with adjuvant chemotherapy in one patient. The rest of the patients were treated by transurethral resection of the tumor, with adjuvant radiotherapy in two cases and bilateral cutaneous ureterostomy in one due to the advanced stage. Mean survival was 20 months ranging from 1 to 91 months. Only two patients are alive, both after radical surgery. CONCLUSIONS: The squamous cell carcinoma, in both its forms, pure and mixed, is an aggressive tumor. The late diagnosis of these tumors and their biological behaviour entail a bad prognosis. Only early diagnosis and radical treatment may improve prognosis.