Malignant Vesical Tumors Following Spinal Cord Injury

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Abstract
We present 11 male patients with spinal cord injury and neurogenic bladder disease in whom malignant vesical tumors developed. The incidence of these tumors in our spinal cord injury unit was 2.3 percent. We investigated retrospectively the clinical, endoscopic and radiographic diagnoses, and analyzed the treatment. The most common presenting symptoms were recurrent urinary infections, hematuria and stone disease. Two patients presented with abdominal symptomatology (a large abdominopelvic mass and peritonitis). Endoscopic evaluation was nonspecific in 8 patients (72 percent). Squamous cell carcinoma was present in 9 patinets (81 percent). One patient had pure transitional cell carcinoma, and 1 had mixed squamous and transitional cell cancer. Cytology was of no value in these patinets. The presence of local invasion and bulky disease suggests that ultrasonography or computerized tomography of the abdomen and pelvis should be included during followup. Radical cystoprostatectomy with pelvic lymphadenectomy is the recommended therapy for localized disease. The presence of active or recurrent urethral disease in 55 percent of the patinets indicated that urethrectomy also should be performed.