Transitional Cell Carcinoma(TCC) is the commonest malignancy of the urinary tract. TCC along with squamous cell carcinoma and adenocarcinoma make up the group of epithelial derived malignancies of the bladder, which together, are responsible for over 90% of the malignancies of the bladder.
Appropriate screening modalities include urinalysis, IVP, and cystoscopy. These lesions can appear as a papillary or sessile filling defect in the bladder wall on IVP. Differential diagnostic considerations would include multiple non-epithelial primary neoplasms (leiomyoma,fibroma,lymphoma,etc), metastatic disease, inflammatory etiologies, and infectious etiologies.
If the tumor is superficial (70%), transurethral resection and multiple biopsies are sufficient for both diagnosis and cure. If the tumor is invasive, anatomic staging with CT or MR and sometimes US is indicated. The most common staging sytem used is the TNM classification. Treatment for invasive malignancies include segmental cystectomy, pelvic lymphadenectomy, radical cystectomy, pelvic radiation, and systemic chemotherapy depending on the specific TNM classification.