Pure squamous cell carcinoma of the bladder in western countries - Report on 19 consecutive cases

Introduction: Pure squamous carcinoma (SCC) is a rare entity in western reg ions. The management of SCC still remains similar to that of transitional c arcinoma, although it is a different entity. A retrospective review can be helpful in understanding the biological behavior of this uncommon vesical t umour. Material and Methods: Nineteen consecutive cases of pure SCC of the bladder , not related to bilharziasis or spinal cord injury, are herein reported. F ifteen patients were submitted to radical cystectomy, combined with emascul ation in 1 case and unilateral nephroureterectomy in another. Partial cyste ctomy was performed in 1 patient and transurethral resection followed by ra diotherapy in 3 more cases. Involvement of prostatic urethra and upper urin ary tract was evident in 9 (47.3%) and 5 patients (26.3%), respectively. Fo ur patients were submitted to neoadjuvant chemotherapy and 1 to presurgical radiotherapy without any objective response. Adjuvant chemotherapy was per formed in 3 patients. At a mean follow-up of 52 months, 6 patients (31.5%) are alive without any evidence of disease. SCC antigen was monitored in 5 p atients. The possible role of this marker in bladder SCC is discussed. Conclusions: Invasion of the upper urinary tract and prostatic urethra seem s more common in SCC than in transitional cell carcinoma. Distant metastase s are rare. Most patients die after attempts of locoregional control of the tumor have failed. Extensive surgery is recommended. Preoperative radiothe rapy should be considered since pelvic recurrences are the leading cause of progression in squamous cell carcinoma. Copyright (C) 2000 S. Karger AG, B asel.