Histological changes due to intravesical instillation of mitomycin C.
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.
Urology Department, Indisa Clinic, Santiago, Chile. dr.octaviocastillo@gmail.com
Octavio A
OA
Castillo
Eduardo
E
Landerer
Miguel
M
Feria-Flores
Ivar
I
Vidal-Mora
Carmen
C
Franco
D000283:Administration, Intravesical; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D003558:Cystoscopy; D003937:Diagnosis, Differential; D053159:Dysuria / Q000139:chemically induced / Q000473:pathology; D006417:Hematuria / Q000139:chemically induced / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000188:drug therapy*; D001743:Urinary Bladder / Q000187:drug effects* / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery
D000970:Antineoplastic Agents; D016685:Mitomycin