A 70-year-old man presents to his primary care physician with symptoms of urinary frequency, urgency, and hematuria. He has been treated for urinary tract infections (UTIs) multiple times in the past year, but his symptoms persist. A cystoscopy is performed, revealing a suspicious lesion in the bladder.
Which of the following statements is true regarding carcinoma of the bladder?
A. Is primarily of squamous cell origin.
B. Is preferentially treated by radiation.
C. May be treated conservatively by use of intravesical agents even if it invades the bladder muscle. D. May mimic an acute UTI with irritability and hematuria.
Answer:
The Correct Answer is: D. May mimic an acute UTI with irritability and hematuria
Explanation:
May mimic an acute UTI with irritability and hematuria (D):
– Bladder carcinoma can present with symptoms that mimic a urinary tract infection (UTI), including urinary frequency, urgency, dysuria (painful urination), and hematuria (blood in the urine). These symptoms can lead to misdiagnosis and delayed identification of the cancer.
Explanation of Incorrect Options:
Is primarily of squamous cell origin (A):
– The most common type of bladder cancer is transitional cell carcinoma (urothelial carcinoma), not squamous cell carcinoma. Transitional cell carcinoma accounts for the vast majority of bladder cancer cases in the United States and other Western countries. Squamous cell carcinoma of the bladder is less common and often associated with chronic irritation or infection.
Is preferentially treated by radiation (B):
– While radiation therapy can be used in the treatment of bladder cancer, it is not the primary treatment modality. The standard treatment for muscle-invasive bladder cancer typically involves radical cystectomy (surgical removal of the bladder) with or without chemotherapy. Non-muscle-invasive bladder cancer is often treated with transurethral resection of the bladder tumor (TURBT) followed by intravesical therapy.
May be treated conservatively by use of intravesical agents even if it invades the bladder muscle (C):
– Muscle-invasive bladder cancer (MIBC) usually requires more aggressive treatment, such as radical cystectomy or combined modality therapy (surgery, chemotherapy, and/or radiation). Intravesical therapy is typically reserved for non-muscle-invasive bladder cancer (NMIBC). It is not appropriate as the sole treatment for muscle-invasive disease.
In conclusion, bladder carcinoma may mimic an acute UTI with irritability and hematuria, making option D the correct answer.