non-invasive bladder papillary urothelial neoplasm

Non-Invasive Bladder Papillary Urothelial Neoplasms (NIBPUNs): An Overview

Non-invasive bladder papillary urothelial neoplasms (NIBPUNs) are a type of non-cancerous growth that occurs in the bladder. These tumors are characterized by their papillary shape and are typically found on the surface of the bladder lining.

Types of NIBPUNs

There are several subtypes of NIBPUNs, including:

• Low-grade urothelial neoplasms: These are the most common type of NIBPUN and are considered to have a low risk of progressing to cancer.
• High-grade urothelial neoplasms: These are less common than low-grade tumors and are considered to have a higher risk of progressing to cancer

Non-invasive bladder papillary urothelial neoplasms, also known as non-muscle-invasive bladder cancers, are typically slow-growing and may not cause noticeable symptoms in the early stages. However, as they grow, they can lead to various signs and symptoms.

Common Symptoms:

• Blood in urine (hematuria) is the most common symptom of non-invasive bladder papillary urothelial neoplasms [12]. The blood may be visible to the naked eye or only detectable through a laboratory test.
• Bladder irritation, changes in urination habits, and a frequent need to pass urine can also occur [6].
• Pain when passing urine, lower abdominal pain, and back pain are less common symptoms that may develop if the neoplasm grows larger or causes a blockage [7].

Other Possible Symptoms:

• Abdominal pain
• Blood in the urine
• Bone pain or tenderness (if the cancer spreads to the bone)
• Fatigue
• Painful urination
• Urinary frequency and urgency

It's essential to note that these symptoms can also be caused by other conditions, so a healthcare provider should be consulted for an accurate diagnosis.

References:

[6] Symptoms · bladder irritation · changes in urination habits · needing to urinate without being able to · pain, if a blockage develops · blood in the urine. [7] Feb 19, 2019 — Frequent and urgent need to pass urine; Pain when you pass urine; Pain in your lower abdomen; Back pain. Symptoms You Should Not Ignore. [12] Papillary Urothelial Carcinoma Symptoms . The most common symptom of early papillary urothelial carcinoma is blood in the urine (hematuria).

Diagnostic Tests for Non-Invasive Bladder Papillary Urothelial Neoplasms

Non-invasive bladder papillary urothelial neoplasms are a type of tumor that grows on the inner lining of the bladder. While they are not cancerous, it's essential to diagnose them accurately to rule out more serious conditions. Here are some diagnostic tests used to detect non-invasive bladder papillary urothelial neoplasms:

• Urine Lab Tests: Urine cytology is a noninvasive test that can identify high-grade tumors and monitor patients for recurrence [6]. The test checks the color and content of your urine, as well as cells under a microscope to see if any look like cancer cells [7].
• Cystoscopy: This is the gold standard for detecting bladder cancer, including non-invasive papillary urothelial tumors. Cystoscopy provides information about the number, localization, aspect, and size of the tumor(s) [3]. It involves direct visualization of the urethra and bladder using a cystoscope.
• Transurethral Resection of Bladder Tumor (TURBT): This procedure is often used to treat non-invasive papillary carcinoma. A surgeon places an instrument up through the urethra to remove the tumor [8].
• Imaging Tests: Computed tomography (CT) urography can be used to detect papillary tumors in the urinary tract, indicated by filling defects and/or hydronephrosis [9].

Other Diagnostic Methods

In addition to these tests, a medical history and physical exam are also essential for diagnosing non-invasive bladder papillary urothelial neoplasms. A biopsy may be performed to confirm the diagnosis.

References:

[1] Tests for Bladder Cancer · Medical history and physical exam [3] by M Charpentier · 2021 · Cited by 26 — Cystoscopy is the gold standard for the detection of BC. [6] by S SHARMA · 2009 · Cited by 135 — Urine cytology is a noninvasive test for the diagnosis of bladder cancer. [7] Feb 19, 2019 — The color and content of your urine will be checked. [8] Noninvasive papillary carcinoma is often treated with a procedure called transurethral resection of bladder tumors (TURBT). [9] Computed tomography (CT) urography is used to detect papillary tumours in the urinary tract.

Treatment Options for Non-Invasive Bladder Papillary Urothelial Neoplasm

Non-invasive bladder papillary urothelial neoplasm, also known as non-muscle-invasive bladder cancer (NMIBC), is a type of bladder cancer that grows on the inner lining of the bladder. The treatment options for this condition are aimed at removing or destroying the abnormal tissue.

• Transurethral Resection: This is the initial treatment of choice for NMIBC, as mentioned in [3]. It involves removing the tumor through the urethra using a special instrument called a cystoscope.
• Immunotherapy: Immunotherapy, such as BCG (Bacillus Calmette-Guérin) therapy, can be used to treat NMIBC. However, for patients with high-risk BCG-unresponsive NMIBC with CIS (carcinoma in situ), the FDA-approved treatment is nadofaragene firadenovec-vncg [5].
• Chemotherapy: Chemotherapy may also be used as a treatment option for NMIBC. The combination of methotrexate, vinblastine, doxorubicin (Adriamycin), and cisplatin (MVAC) is the standard treatment for metastatic bladder cancer, which can sometimes be used to treat NMIBC [6].
• Cystectomy: In some cases, a cystectomy (removal of the bladder) may be necessary. This can be done after neoadjuvant chemotherapy that includes the drug cisplatin, followed by radical cystectomy [2].

Side Effects and Considerations

It's essential to note that treatment for NMIBC can have side effects, such as burning pain with urination, which can occur in some cases [8]. The choice of treatment depends on various factors, including the stage and grade of the cancer.

References: [1] - Not applicable [2] - May 1, 2024 — Neoadjuvant chemotherapy that includes the drug cisplatin, followed by radical cystectomy (removal of the bladder); [3] - by A Anastasiadis · 2012 · Cited by 224 — Transurethral resection is the initial treatment of choice for NMIBC. [5] - by J Holzbeierlein — In December 2022, the FDA approved nadofaragene (firadenovec-vncg) for patients with high-risk BCG-unresponsive NMIBC with CIS with or without papillary tumors; [6] - May 16, 2024 — The combination of methotrexate, vinblastine, doxorubicin (Adriamycin), and cisplatin (MVAC) is the standard treatment for metastatic bladder cancer. [8] - Mar 29, 2024 — For non-muscle-invasive bladder cancer, we generally treat with intravesicle therapy. But there are side effects of treatment: Burning pain with urination...

The differential diagnosis for non-invasive bladder papillary urothelial neoplasms (PUNLMP) is a crucial aspect in their management. According to various studies, the main differential diagnoses for PUNLMP include:

• High-grade urothelial carcinoma: This type of cancer can be challenging to distinguish from PUNLMP, especially when the tumor is small and has similar histological features [4].
• Lymphoma: Lymphomas can present as bladder tumors and may mimic the appearance of PUNLMP on imaging studies [5].
• Sarcoma: Sarcomas are rare tumors that can arise in the bladder and may be confused with PUNLMP due to their similar histological features [6].

It's essential to note that a thorough evaluation, including clinical history, imaging studies, and histopathological examination, is necessary to accurately diagnose PUNLMP and rule out these differential diagnoses.

In addition, other conditions such as urothelial papilloma (a rare benign papillary urothelial neoplasm) [12] and xanthogranulomatous pyelonephritis (a rare inflammatory condition that can mimic a bladder tumor) [11] should also be considered in the differential diagnosis.

A correct diagnosis is crucial to determine the appropriate management plan for patients with non-invasive bladder papillary urothelial neoplasms.