title: Clinicopathologic characterization of intradiverticular carcinoma of urinary bladder - a study of 22 cases from a single cancer center.
abstract: BACKGROUND
  To examine histopathologic features and clinical outcomes of intradiverticular bladder carcinomas.
  
  
  METHODS
  Twenty-two consecutive patients with intradiverticular bladder carcinoma treated with either endoscopic transurethral resection or partial or radical cystectomy at a single institution between years of 1995 to 2011. Clinicopathologic characteristics and oncologic outcomes of patients were retrospectively analyzed, including tissue histology re-review by genitourinary pathologists.
  
  
  RESULTS
  Histologically, 9 cases (41%) were non-invasive papillary urothelial carcinoma, 13 cases (59%) were invasive urothelial carcinoma, including three cases of small cell carcinoma. Final pathology revealed synchronous extradiverticular urothelial carcinomas in 6 out of 9 cases (67%) of non-invasive and 2 out of 10 cases (20%) invasive intradiverticular urothelial carcinoma, respectively. More than half of cases (13/22, 59%) showed a distinctive hypertrophic layer of muscularis mucosae. There was no statistical difference in disease free survival or overall survival between non-invasive and invasive tumors within approximately 3 years of follow up (mean 38 months, median 32 months). While stage T3 patients generally did poorly, oncologic outcomes for stage T1 patients were no different than those of stage Ta.
  
  
  CONCLUSIONS
  Intradiverticular carcinomas are often associated with a hypertrophic layer of muscularis mucosae that can potentially confound tumor staging. Non-invasive intradiverticular urothelial carcinomas are more likely to have coexisting synchronous extradiverticular lesions. The absence of a muscularis propria layer may not necessarily predispose T1 tumors to more aggressive disease.
  The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/13000_2014_222.
authors.affiliation: Department of Pathology and Laboratory Medicine, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY, 14263, USA. zhonghu@umdnj.edu.|Current address: Department of Pathology and Laboratory Medicine, Robert Wood Johnson Medical School, UMDNJ, One Robert Wood Johnson Place - MEB 212, New Brunswick, NJ, 08901, USA. zhonghu@umdnj.edu.
authors.forename: Hua
authors.initials: H
authors.lastname: Zhong
authors.affiliation: Department of Medicine, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY, 14263, USA. Saby.George@RoswellPark.org.
authors.forename: Saby
authors.initials: S
authors.lastname: George
authors.affiliation: Department of Urology, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY, 14263, USA. Eric.Kauffman@RoswellPark.org.
authors.forename: Eric
authors.initials: E
authors.lastname: Kauffman
authors.affiliation: Department of Urology, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY, 14263, USA. Khurshid.Guru@RoswellPark.org.
authors.forename: Khurshid
authors.initials: K
authors.lastname: Guru
authors.affiliation: Department of Pathology and Laboratory Medicine, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY, 14263, USA. Gissou.Azabdaftari@roswellpark.org.
authors.forename: Gissou
authors.initials: G
authors.lastname: Azabdaftari
authors.affiliation: Department of Pathology and Laboratory Medicine, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY, 14263, USA. bo.xu@roswellpark.org.
authors.forename: Bo
authors.initials: B
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D015653:Cystectomy; D003558:Cystoscopy; D018572:Disease-Free Survival; D004240:Diverticulum / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D006984:Hypertrophy; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009518:New York; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery