Santo Cancro

di Vincenzo Fiore Marrese

The Grade I transitional cell carcinoma (papilloma) arises on the paler mucous membrane of the bladder and has a large base that hides the point of implantation like a mushroom hides its base. It is pink or red in color.


It is friable and soft. Only under some tension does it become evident that this tumor attached by an often flat and very soft pedicle formed for the most part by the mucose membrane itself. At times the bladder can be entirely replaced by this well-differentiated neoplasm (fig. 510.) If multiple tumors are present, they may show varying degrees of differentiation. Grossly the well-differentiated neoplasm are usually pedunculated.

As these tumors become undifferentiated the proportion of papillary ones among them decreases. Infrequently the highly malignant carcinomas are papillary in character. In the poorly differentiated tumors ulceretoion, infection and fixation are common. When a papillary tumor shows poor differentation, it tends to invade the base and become fixed. Later it ulcerates and becomes infected, but the majority of transitional cells carcinomas develop as a papillary mass. Epidermoi Carcinomas (only a small percentage of the total number of carcinomas) are usually firm, deeply ulcerated, and heavily infected and often involve the

musculature of the bladder. In a large series of single bladder tumors of the transitional cell type collected by Carcinoma Registry of the American Urological Society, the points of origin where as shown in Table 55 (Mostofi). In 243 cases reported by Barringer 195 (80%) where around the bladder base

near or involving the internal uretra or one or both ureters. In another series reported by the Registry there were 643 single and 250 multiple bladder carcinomas, 45% of which were larger then 5 cm.

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