A Study of Epithelial Neoplasms of the Urinary Bladder

Abstract

The gradation of malignancy of bladder epitheliomas according to Bro-der''s classification was made of the original tumor and the recurrences. In 63 tumors there was increase of malignancy in only 2, namely, grade 1-3, and grade 2-3. There was, however, some doubt because of time interval if these were true recurrences or independent growths. In 119 cases the reliability of the positive report of malignancy of the cystoscopically removed specimen as to grade was established as proved by subsequent surgery. A single or even 2 reports of inflammatory tissue are never sufficient to warrant the exclusion of malignancy in the cystoscopically removed specimen. On 83.33% of these cases, where the first specimen was reported inflammatory tissue, and late specimens either surgically or cystoscopically removed were reported malignant, the grade of malignancy was either 3 to 4, that is, in the most malignant groups. In 64 tumors the grade of malignancy was ascertained in 3 areas, namely, base, surface, and muco-tumor junction and no variation could be found in the grade of malignancy in these areas in the same tumor. There is very little ground for the belief that the majority of bladder epitheliomas arise from the benign papillomas, as tumors as a rule remain of the same degree of malignancy in the recurrence.