Updated: 2/13/2018

Squamous Cell Carcinoma (SCC) of the Bladder

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Snapshot
  • A 60-year-old man from East Africa presents with blood in the urine. Though it did not hurt, he was scared by the amount of blood. He endorses some urinary urgency, but attributed it to old age. A urine sample is positive for gross blood. An KUB reveals calcification of the bladder. A cystoscopy with biopsy is ordered for further evaluation.
Introduction
  • A type of bladder cancer
    • urothelial vs non-urothelial
    • squamous cell carcinoma is a non-ureothelial bladder cancer
  • Risk factors
    • Schistosoma haematobium infection
      • chronic inflammation by laying of eggs
      • IgE and eosinophilic infiltration
    • chronic UTI
    • smoking
  • Epidemiology
    • 3-5% of all bladder cancers in North America
    • 75% of all bladder cancers where Schistosoma haematobium is endemic
      • Middle east
      • East Africa
Presentation
  • Symptoms
    • painless hematuria
      • can be microscopic or grossly visible
    • irritative voiding symptoms
      • frequency
      • urgency
      • dysuria
Evaluation
  • Gold standard
    • cystoscopy with biopsy
  • Radiography
    • calcification of bladder and distal ureters
Differential Diagnosis
  • Adenocarcinoma of bladder
  • Transitional cell carcinoma of bladder
Treatment
  • Cystectomy for localized disease
    • lymph node dissection
  • Radiation/chemotherapy controversial
Prognosis, Prevention, and Complications
  • Prognosis
    • poor with local invasion
    • metastases rare
    • should consider palliative care
  • Prevention
    • cessation of smoking
  • Complications
    • death
 

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