An 82-year-old male with ...

An 82-year-old male with a history of prostate cancer presented to the urology department with a complaint of intermittent gross hematuria lasting for a week. He was not taking any anticoagulant or antiplatelet medications. His previous prostate cancer treatment involved brachytherapy monotherapy using 80 iodine-125 implants, after which he showed no recurrence or metastasis over six years, and his serum prostate-specific antigen level decreased to 0.03 ng/ml. Urine analysis indicated no signs of pyuria. The patient didn't experience lower urinary tract symptoms. Physical examinations were unremarkable. The patient's routine lab results were normal, and urine cytology showed no signs of bladder cancer. Cystoscopy revealed multiple papillary tumors on the posterior wall's right side without indications of radiation-induced cystitis. Computed tomography (CT) confirmed several smaller than 1 cm in diameter bladder tumours and showed no other abnormalities. The prostate volume measured 25.1 ml. These findings suggest the presence of non-invasive bladder cancer. The urology department conducted a transurethral resection of the bladder tumor (TURBT), during which they removed and coagulated several nodular tumors located on the right posterior wall. Following the TURBT procedure, the gross hematuria subsided. The examination of the TURBT tissue using HE staining revealed mildly atypical epithelial proliferation with inverted growth. Additionally, the basal cell marker p63 distinctly stained a two-layered structure. The negativity for MIB-1, with staining detected in less than 1% of the tumor cells, indicated a low proliferative potential. Some tumor cells exhibited weak staining for p53, which appeared in a scattered but a not diffused pattern.