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Papillary and CIS...relationship?

11 years 3 months ago #18927 by Joey
I also was dx with TA low grade in December. First cysto in April showed no tumor, cytology and fish were negative and three pathologist stated atypical cells on biopsy. One said focal CIS.

Two weeks later, had a larger portion of the site removed, kidney/ureter wash was negative, two pathologists said no sign of carcenoma on biopsy, the same pathologist who saw the CIS the first time, saw it again in the biopsy.

Now deciding on treatment as just had stent removed after 7 weeks.

Joe

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11 years 3 months ago #18922 by Patricia
I had a single papillary tumor arising out of CIS......they only thought they were looking at a tiny little tumor until they got in there and discovered the CIS lurking beneath and into the muscle. Its very sneaky! Pat

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11 years 3 months ago #18914 by sara.anne
Cynthia, thanks so much for the reference. I found the following quote from the same article very interesting and a real answer to my question

"More than 50% of patients with CIS have coexisting papillary cancer. In general, the papillary tumor is diagnosed initially and CIS is discovered during the evaluation and treatment of the papillary tumor."

However, that really doesn't answer the question of which came first, "the chicken or the egg." Inquiring minds want to know!!

Sara Anne

Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
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11 years 3 months ago #18908 by Cynthia
Found this and thought it might answer your question


Carcinoma In Situ of the Urinary Bladder

Published on emedicine.com

Stanley A Brosman, MD, Clinical Professor, Department of Urology, University of California at Los Angeles Medical School Oct. 2007

http://www.emedicine.com/med/TOPIC3022.HTM

The most common molecular biologic pathway for TCCs involves the development of a papillary tumor that projects into the bladder lumen and, if untreated, eventually penetrates the basement membrane, invades the lamina propria, and then continues into the bladder muscle, where it can metastasize. Nearly 90% of transitional cell bladder tumors exhibit this type of behavior. The remaining 10% follow a different molecular pathway and are called carcinoma in situ (CIS). This is a flat type of tumor that spreads along the surface of the bladder and, over time, may progress to an invasive form of cancer that behaves the same as invasive TCC. CIS can develop alone or in association with papillary tumors.


Cynthia Kinsella
T2 g3 CIS 8/04
Clinical Trial
Chemotherapy & Radiation 10/04-12/04
Chemotherapy 3/05-5/05
BCG 9/05-1-06
RC w/umbilical Indiana pouch 5/06
Left Nephrectomy 1/09
President American Bladder Cancer Society

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11 years 3 months ago #18904 by Nix
I also have papillary - Ta and CIS. My papillary was found in Nov 06 - I was clear for 3 Cystos then on the forth - red velvety patches were biopsied and sure enough CIS. So I would have to say, according to my history they are independent. Some people just get a papillary Ta once and it is removed - then nothing else comes back . I have never had another tumor - just the red patches. Of course, I am not happy about
the CIS, however BCG does work well on CIS and not just Ta. I guess I am looking for a silver lining to the cloud :)!

Nancy S
Ta CIS
dx Ta 11/06
dx Ta CIS 10/07

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11 years 3 months ago #18899 by sara.anne
One question that I cannot seem to find an answer for is the relationship between papillary and CIS. Is papillary a PRECURSER to CIS or are they independent? My first biopsy showed definite papillary and a lot of inflammation/uncertainty. My uro then did a second biopsy and the diagnosis came back CIS. My reading seems to indicate that you can have one without the other. Any thoughts/information on the relationship?

Sara Anne

Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
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