Histological changes due to intravesical instillation of mitomycin C

Arch Esp Urol. 2012 Jun;65(5):578-82; discussion 582.
[Article in English, Spanish]

Abstract

Objective: Transurethral resection (TUR) is highly effective in the local control of superficial bladder cancer. However, the recurrence rate can reach 80% of the cases. Adjuvant intravesical chemotherapy may decrease significantly tumor recurrence. We describe a bladder adverse reaction to mitomycin C as adjuvant therapy for non-invasive bladder cancer

Methods: Three patients with diagnosis of pTa G1 urothelial carcinoma were treated by TUR plus an instillation of 40 mg. of mitomicin C. A month later, the patients were attended for dysuria and hematuria. Cystoscopy and bladder biopsy were performed in all cases.

Results: Multiple sessile lesions suspicious of tumor recurrence were found on cystoscopy. The histopathological diagnosis disclosed the existence of severe atypia of the urothelium and stromal changes similar to those observed after radiotherapy

Conclusions: Adjuvant intravesical chemotherapy with mitomycin C may cause local reactions with macroscopic patterns similar to tumoral recurrences.

MeSH terms

  • Administration, Intravesical
  • Aged
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / pharmacology
  • Antineoplastic Agents / therapeutic use
  • Carcinoma, Transitional Cell / diagnosis
  • Carcinoma, Transitional Cell / drug therapy*
  • Carcinoma, Transitional Cell / pathology
  • Carcinoma, Transitional Cell / surgery
  • Chemotherapy, Adjuvant
  • Combined Modality Therapy
  • Cystoscopy
  • Diagnosis, Differential
  • Dysuria / chemically induced
  • Dysuria / pathology
  • Hematuria / chemically induced
  • Hematuria / pathology
  • Humans
  • Male
  • Middle Aged
  • Mitomycin / administration & dosage
  • Mitomycin / adverse effects*
  • Mitomycin / pharmacology
  • Mitomycin / therapeutic use
  • Neoplasm Recurrence, Local / diagnosis
  • Neoplasm Recurrence, Local / drug therapy*
  • Urinary Bladder / drug effects*
  • Urinary Bladder / pathology
  • Urinary Bladder Neoplasms / diagnosis
  • Urinary Bladder Neoplasms / drug therapy*
  • Urinary Bladder Neoplasms / pathology
  • Urinary Bladder Neoplasms / surgery

Substances

  • Antineoplastic Agents
  • Mitomycin