title: Extravesical Pagetoid Spread of Urothelial Carcinoma in Situ. A Report of Five Cases.
abstract: BACKGROUND
  Urothelial carcinoma in situ (CIS) of the bladder is classified as a flat lesion of the urothelium; it has a tendency to be multifocal and carries a high risk of recurrence and persistence. Approximately one-third of patients with urothelial CIS of the bladder develop invasive carcinoma if left untreated. There are a few reported cases of extravesical intramucosal extension (pagetoid spread) of urothelial CIS without prior documentation of primary muscle-invasive carcinoma.
  
  
  METHODS
  We present 5 cases of urothelial CIS that exhibited pagetoid spread to prostatic ducts, seminal vesicles, and the vagina.
  
  
  CONCLUSIONS
  Pagetoid spread of urothelial CIS of the bladder may introduce uncertainty with regard to assignment of proper disease staging, and therefore uncertainty about appropriate cancer management.
authors: Mahmut
authors: M
authors: Akgul
authors: Phillip B
authors: PB
authors: Bomeisl
authors: Gregory T
authors: GT
authors: MacLennan
mesh_terms: D000368:Aged; D002278:Carcinoma in Situ / Q000473:pathology*; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000473:pathology; D001743:Urinary Bladder / Q000473:pathology; D014571:Urologic Neoplasms / Q000175:diagnosis / Q000473:pathology*