CURRENT METHODS OF ASSESSING AND TREATING CARCINOMA IN SITU OF THE BLADDER WITH OR WITHOUT INVOLVEMENT OF THE PROSTATIC URETHRA

Carcinoma in sitii (CIS) of the bladder, which was first described by Melicow in 1952, is the precursor of invasive cancer and may coexist with noninvasive papillary cancer. ’ A spectrum of biological aggressiveness exists for cases of CIS. There may be a long primary in situ phase or a rapid course with a neoplasm becoming invasive after a short in situ phase.? A form fruste lesion of CIS that may represent biologically innocuous epithelium composed of cells having the cytomorphologic features of malignant epithelium without progression has been proposed. The former conferences for consensus development in clinical bladder cancer research recommend that the term transitional CIS is limited to flat lesions with enough cellular anaplasia to be recognized as Such lesions should be graded as grade 2 or grade 3 . The majority will be classified as grade 3 . The entity of CIS in morphological terms should be defined as precisely as possible. The morphologic definition of CIS may be arbitrary but nevertheless critical as a starting point for future discussion.’ Histologically there is anaplasia, disarrangement and/or loss of cellular polarity. The lesion is morphologically flat on cystoscopic examination. Based on the content of the first and second working party reports CIS is therefore defined and classified as follows.2,4