Case #5
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Physical Exam
01/21/XX
48-year-old male; works in tanning factory.
No abd masses; prostate is normal size, but is immobile
X-Rays & Scans
01/21/XX
CXR NEG
01/27/XX
IVP 2.5 cm bladder tumor arising at the urethral orifice, question prostatic and urethral extension
Scopes/Lab
01/21/XX
CBC Normal
Operative Findings
01/27/XX
TURB: Polypoid bladder tumor at the urethral orifice, somewhat bulky, suggest resection
01/28/XX
Exploratory laparotomy, total cystectomy and lymph node dissection, and prostatectomy (with seminal vesicles); bladder tumor was fixed to and involved the prostatic urethra and the prostate
Pathological Reports
01/27/XX
TURB: Mult fragments, Mod Diff invasive transitional cell ca
01/28/XX
Total cystectomy, LN dissect, and prostatectomy: Mod Diff TCC of the bladder w/ invasion of the prostatic urethra and gross prostate; 2 of 5 iliac LNs (all less than 2 cm) and 4 of 6 inguinal LNs (no size given) are + for mets
Treatment
01/27/XX
Transurethral resection (TURBT)
01/28/XX
Cystectomy, LN dissection, prostatectomy
03/10/XX
Multi-agent chemotherapy (gemcitabine, cisplatin)



