Bladder Cancer pp 141-159 | Cite as

Carcinoma In Situ

  • T. B. Hargreave
Part of the Clinical Practice in Urology book series (PRACTICE UROLOG)


This lesion has also been called ‘flat carcinoma in situ’ (Riddle et al. 1976) or ‘flat intraepithelial neoplasia’ (Barlebo et al. 1972). These are attempts to define the epithelial abnormality where there is an overtly malignant cellular pattern of the epithelial cells but without invasion or papillary growth. Unfortunately, the histological criteria are not clear cut (see Chap. 2, p. 30) and different pathologists will not necessarily agree: One might report severe dysplasia, whereas another may report the same slide to show carcinoma in situ and a third may attempt to grade the in situ change. The problem is compounded by the different clinical patterns of the disease. Some possible criteria for classification of carcinoma in situ are listed in Table 7.1; however, because of the comparative rarity of the lesion, such classification is not usually made and therefore the natural history of the untreated lesion in each category has not been fully documented.


Bladder Cancer Transitional Cell Carcinoma Bacillus Calmette Guerin Mucosal Biopsy Intravesical Therapy 
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  1. Barlebo H, Sorenson BL, Ohlsen AS (1972) Carcinoma in situ of the urinary bladder: flat intraepithelial neoplasia. Scan J Urol Nephrol 6: 213–223CrossRefGoogle Scholar
  2. Boyd PRJ, Burnand KG (1974) Site of bladder tumour recurrence. Lancet II: 1290–1292CrossRefGoogle Scholar
  3. Brosman SA (1982) Experience with Bacillus Calmette-Guérin in patients with superficial bladder cancer. J Urol 128: 27–30PubMedGoogle Scholar
  4. Chibber PJ, McIntyre MA, Hindmarsh JR, Hargreave TB, Newsam JE, Chisholm GD (1981) Transitional cell carcinoma involving the prostate. Br J Urol 33: 605–609CrossRefGoogle Scholar
  5. Connolly JG (1979) Bladder brush. Urology 14: 177–178PubMedCrossRefGoogle Scholar
  6. Cooper PH, Waisman J, Johnston WH, Skinner DG (1973) Severe atypia of transitional epithelium and carcinoma of the urinary bladder. Cancer 31: 1055–1060PubMedCrossRefGoogle Scholar
  7. Devonec M, Darzynkiewicz Z, Whitmore WF, Melamed MR (1981) Flow cytometry for follow-up examinations of conservatively treated low stage bladder tumors. J Urol 126: 166–170PubMedGoogle Scholar
  8. de Voogt HJ, Rathert P, Beyer-Boon ME (1977) Carcinoma in situ. In: de Voogt HJ, Rathert P, Beyer-Boon ME (eds) Urinary cytology. Springer, Berlin Heidelberg New York, pp 127–133CrossRefGoogle Scholar
  9. Edsmyr F (1981) Intravesical therapy with doxorubicin in patients with superficial bladder tumours. In: Oliver RTD, Hendry WF, Bloom HJG (eds) Bladder cancer: principles of combination therapy. Butterworths, London, pp 107–114Google Scholar
  10. Edsmyr F, Berlin T, Boman J, Esposti PL, Gustagson H, Wikstrom H (1979) Intravesical therapy with Adriamycin in patients with superficial bladder tumours In: Proceedings of the First Conference on Treatment of Urinary Tract Tumors with Adriamycin, Tokyo, 1979, pp 50–57. Obtainable from Montedison PharmaceuticalsGoogle Scholar
  11. England HR, Molland EA, Oliver RTD, Blandy JP (1981) Systemic cyclophosphamide in flat carcinoma in situ of the bladder. In: Oliver RTD, Hendry WF, Bloom HJG (eds) Bladder cancer: principles of combination therapy. Butterworths, London, pp 97–105Google Scholar
  12. Farrow GM, Utz DC, Rife CC (1976) Morphological and clinical observations of patients with early bladder cancer treated with total cystectomy. Cancer Res 36: 2495–2501PubMedGoogle Scholar
  13. Farrow GM, Utz DC, Rife CC, Greene LF (1977) Clinical observations on sixty-nine cases of in situ carcinoma of the urinary bladder. Cancer Res 37: 2794–2798PubMedGoogle Scholar
  14. Farsund T, Laerum OD, Høstmark J, Jorfald G (1984) Local chemotherapeutic effects in bladder cancer demonstrated by selective sampling and flow cytometry. J Urol 131: 22–32PubMedGoogle Scholar
  15. Finan PJ, Anderson J, Doyle PT, Lennox ES, Bleehen NM (1982) The prediction of invasive potential in superficial transitional cell carcinoma of the bladder. Br J Urol 54: 720–725PubMedCrossRefGoogle Scholar
  16. Glashan RW (1982) Intravesical therapy with Adriamycin in urothelial dysplasia and early carcinoma in situ. Can J Surg 25: 30–32PubMedGoogle Scholar
  17. Harris MJ, Schwinn CP, Morrow JW, Browell BM (1971) Exfoliative cytology of the urinary irrigation specimen. Acta Cytol 15: 385–399PubMedGoogle Scholar
  18. Heney NM, Daly J, Prout GR Jr, Nieh PT, Heaney JA, Trebeck NF (1978) Biopsy of apparently normal urothelium in patients with bladder carcinoma. J Urol 120: 559–560PubMedGoogle Scholar
  19. Herr HW, Pinsky CM, Whitmore WJ Jr, Oettgen HF, Melamed MR (1983) Effect of intravesical Bacillus Calmette-Guérin (BCG) on carcinoma in situ of the bladder. Cancer 51: 1323–1326PubMedCrossRefGoogle Scholar
  20. Hewitt CB, Babiszewski JF, Antunez AR (1981) Update on intracavitary radiation in the treatment of bladder tumours. J Urol 126: 323–325PubMedGoogle Scholar
  21. Hicks RM (1982) The development of bladder cancer. In: Williams DI, Chisholm GD (eds) Scientific foundations in urology. Heinemann, London, pp 711–722Google Scholar
  22. Hisazumi H, Misaki T, Mioshi N, Katsusuke N, Misaki T (1984) Whole bladder wall photo radiation therapy for carcinoma in situ: a preliminary report. J Urol 131: 884–887PubMedGoogle Scholar
  23. Jacobi GH, Kurth KH (1980) Studies on the intravesical action of topically administered G3H-doxorubicin hydrochloride in men: plasma uptake and penetration. J Urol 124: 34–37PubMedGoogle Scholar
  24. Jakse G, Hofstadter F, Leither G, Marberger H (1980) Carcinoma in situ of the urinary bladder. A diagnostic and therapeutic challenge. Urologe [A] 19: 93–99Google Scholar
  25. Kinsey JH, Cortese DA (1980) Endoscopic system for simultaneous visual examination and electronic detection of fluorescence. Rev Sci Instrum 51: 1403–1406PubMedCrossRefGoogle Scholar
  26. Kinsey JH, Cortese DA, Sanderson DR (1978) Detection of hematoporphyrin fluorescence during fibreoptic bronchoscopy to localise early bronchogenic carcinoma. Mayo Clin Proc 53: 594–600PubMedGoogle Scholar
  27. Kirk D, Hinton CE, Shaldon C (1979) Transitional cell carcinoma of the prostate. Br J Urol 51: 575–578PubMedCrossRefGoogle Scholar
  28. Koss LG (1979) Mapping of the urinary bladder: its impact on the concepts of bladder cancer. Hum Pathol 10: 533–548PubMedCrossRefGoogle Scholar
  29. Koss LG, Melamed MR, Kelly RE (1969) Further cytologic and histologic studies of bladder lesions in workers exposed to para-aminodiphenyl; progress report. J Natl Cancer Inst 43: 233–234PubMedGoogle Scholar
  30. Kulatilake AE, Chisholm GD, Olsen EG J (1970) In situ carcinoma of the urinary bladder. Proc R Soc Med 63: 95–97PubMedPubMedCentralGoogle Scholar
  31. Loening S, Narayana A, Yoder L, Slymen S, Weinstein G, Penick G, Culp D (1978) Longitudinal study of bladder cancer with cytology and biopsy. Br J Urol 50: 496–501PubMedCrossRefGoogle Scholar
  32. Melamed MR, Voutsa NG, Grabstald H (1964) Natural history and clinical behaviour of in situ carcinoma of the human urinary bladder. Cancer 17: 1533–1545PubMedCrossRefGoogle Scholar
  33. Melicow MM (1952) Histological study of vesical urothelium intervening between gross neoplasms in total cystectomy. J Urol 68: 261–279PubMedGoogle Scholar
  34. Mintz B, Illmensee K (1975) Normal genetically mosaic mice produced from malignant teratocarcinoma cells. Proc Natl Acad Sci USA 72: 3585–3589PubMedCrossRefPubMedCentralGoogle Scholar
  35. Mishina T, Watanabe H, Fujiwara T, Kobayashi T, Maegawa M, Nakao M, Nakagawa S (1982) Prophylactic use of mitomycin C bladder instillation for preventing the recurrence of bladder tumours. In: Ogana M, Rozencweig M, Staquet MJ (eds) Mitomycin C—current impact on cancer chemotherapy. Exerpta Medica, Amsterdam, pp 153–162Google Scholar
  36. Morales A, Eidinger D, Bruce AW (1976) Intracavitary bacillus Calmette-Guérin in the treatment of superficial bladder tumours. J Urol 116: 180–183PubMedGoogle Scholar
  37. Murphy WM, Nagy GK, Rao MK, Soloway MS, Parija GC, Cox CF, Friedell GH (1979) Normal urothelium in patients with bladder cancer: a preliminary report from the National Bladder Cancer Project Collaborative Group A. Cancer 44: 1050–1058PubMedCrossRefGoogle Scholar
  38. Newman J, Hicks RM (1978) Detection of neoplastic and preneoplastic urothelia by combined scanning and transmission electron microscopy of urinary surface of human rat bladders. Histopathology 1: 15–135Google Scholar
  39. Page BH, Levinson VB, Curwen MP (1978) The site of recurrence of non-infiltrating bladder tumours. Br J Urol 50: 237–242PubMedCrossRefGoogle Scholar
  40. Pinsky CM, Camacho FJ, Kerr D, Braun DW, Whitmore WF Jr, Oettgen H (1982) Treatment of superficial bladder cancer with intravesical Bacillus Calmette-Gúerin (BCG). In: Terry W, Rosenberg S (eds) Immunotherapy of human cancer: present state of trials in man, vol 2. Elsevier North Holland, New York, pp 309–312Google Scholar
  41. Prout GR Jr, Griffin PP, Nocks BN, DeFuria D, Daly JJ (1982) Intravesical therapy of low stage bladder carcinoma with mitomycin C: comparison of results in untreated and previously treated patients. J Urol 127: 1096–1098PubMedGoogle Scholar
  42. Riddle PR, Chisholm GD, Trott PA, Pugh RCB (1976) Flat carcinoma in situ of bladder. Br J Urol 47: 829–833CrossRefGoogle Scholar
  43. Schade ROK, Swinney J (1968) Precancerous changes in bladder epithelium. Lancet II: 943–946CrossRefGoogle Scholar
  44. Schade ROK, Swinney J (1973) The association of urothelial atypism with neoplasia: its importance in treatment and prognosis. J Urol 109: 619–622PubMedGoogle Scholar
  45. Schade ROK, Swinney J (1983) The association of urothelial abnormalities with neoplasia: a 10 year followup. J Urol 129: 1125–1126PubMedGoogle Scholar
  46. Smith JA, Dixon JA (1984) Argon laser phototherapy of superficial transitional cell carcinoma of bladder. J Urol 131: 655–656PubMedGoogle Scholar
  47. Smith G, Elton RA, Beynon LL, Newsam JE, Chishoim GD, Hargreave TB (1983) Prognostic significance of biopsy results of normal looking mucosa in cases of superficial bladder cancer. Br J Urol 55: 665–669PubMedCrossRefGoogle Scholar
  48. Soloway MS (1981) Editorial comment. J Urol 125: 190Google Scholar
  49. Soloway MS, Murphy W, Rav MK, Cox C (1978) Serial multiple-site biopsies in patients with bladder cancer. J Urol 120: 57–59PubMedGoogle Scholar
  50. Utz DC, Farrow GM, Rife CC, Segura JW, Zincke H (1980) Carcinoma in situ of the bladder. Cancer 45: 1842–1848PubMedGoogle Scholar
  51. Wallace DMA, Hindmarsh JR, Webb JN, Busuttil A, Hargreave TB, Newsam JE, Chishoim GD (1979) The role of multiple mucosal biopsies in the management of patients with bladder cancer. Br J Urol 51: 535–540PubMedCrossRefGoogle Scholar
  52. Webb JN (1983) The pathology of bladder cancer. In: Smith PH, Prout GR (eds) Urology I. Bladder cancer. Butterworths International Medical Reviews. Butterworths, London, pp 104–124Google Scholar
  53. Weinstein RS, Koo C, Pauli BU, Jacobs JB, Friedeil GH (1979) Epithelial injury by cystoscopic fluid. Semin Oncol 6: 257–259PubMedGoogle Scholar
  54. Weldon TE, Soloway MS (1975) Susceptibility of urothelium to neoplastic cellular implantation. Urology 5: 824–827PubMedCrossRefGoogle Scholar
  55. Wolf H, Hojgaard K (1983) Urothelial dysplasia concomitant with bladder tumours as a determinant factor for future occurrences. Lancet II: 134–136CrossRefGoogle Scholar
  56. Wolfe JHN, Lloyd-Davies RW (1981) The management of transitional cell carcinoma of the prostate. Br J Urol 53: 253–257PubMedCrossRefGoogle Scholar
  57. Yagoda A, Watson RC, Whitmore WF, Grabstald H, Middleman MP, Krakoff IH (1977) Adriamycin in advanced urinary tract cancer: experience in 42 patients. Cancer 39: 279–285PubMedCrossRefGoogle Scholar
  58. Yates-Bell AJ (1979) Carcinoma in situ of the bladder. Br J Surg 58: 359–364CrossRefGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 1985

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  • T. B. Hargreave

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