CARCINOMA ARISING IN URINARY-BLADDER DIVERTICULA - IMAGING FINDINGS IN 6 PATIENTS

OBJECTIVE. Carcinoma arising within urinary- bladder diverticula has a poorer prognosis than do neoplasms that originate within the main bla dder lumen as a result of early transmural tumor infiltration. Imaging plays an important role in diagnosing and staging the disease. We des cribe the radiologic findings in six patients with pathologically prov ed diverticular carcinomas. MATERIALS AND METHODS. We reviewed the rec ords of six patients who had radiologic examinations and surgically co nfirmed vesical diverticular carcinomas. The examinations included exc retory urography in three patients, cystography in three patients, CT in five patients, and MR imaging in one patient. All patients had hema turia. Five patients had transitional cell carcinoma, and one patient had squamous cell carcinoma. RESULTS. Three of the tumors manifested a s an intraluminal filling defect within a bladder diverticulum on excr etory urograms or cystograms. In one patient, CT scans showed a concen tric soft-tissue tumor in a diverticular neck. Correlative cystograms showed only smooth narrowing in this area. CT and MR imaging showed a tumor within a large diverticulum, which was not visualized on cystogr ams because of obstruction at the diverticular orifice. CONCLUSION. Im aging plays an important role in identifying bladder diverticula as a potential site of occult neoplasm.