Bladder and Prostate-gland removed for bladder cancer

Orange arrow points to the prostate (inked blue) and the blue arrow points to the papillary, friable bladder tumor. As you can see, the bladder shows quite a bit of tumor. Probes are entering through the ureteral orifices. Top aspect is normal fat surrounding bladder.

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Pic 2/2. Orange arrow points to the lumen of the sigmoid colon which contains 7cm worth of invasive bladder cancer. Blue arrow is pointing to the left lateral wall of the bladder.](https://app.figure1.com/case-detail/14361e7b-7bcc-49b5-9d3e-313e51b0f604)

Here is a cystoprostatectomy (Bladder & Prostate) specimen removed for invasive bladder cancer. The prostate is at the bottom of the pic, shown with the green arrow.
This tumor (black arrow) appears obviously necrotic, however the appearance is compounded by the presence of bladder stones. The stones can break down with the help of fluid (urine) and become somewhat of a coarse paste-like consistency. This substance is adherent to, and basically indistinguishable from, the tumor.
In addition to this obvious area, the surrounding mucosa looks concerning as well. Is this the ‘true’ border and size of the tumor or is this just reactive change? Does the area marked with a drawn arrow demonstrate tumor involving the left ureteral orifice? (Probes entering both ureters) Are the margins free of tumor? Is the prostate involved by tumor? These are the many questions we must answer and help the Pathologist answer as a Pathologists’ Assistant.

#Bladder cancer
Cystoprostotectomy - looking in bladder as if it were in patient. Prostate inferior. Tumor is large necrotic mass on posterior wall.](https://app.figure1.com/case-detail/5c6851fc-2b0d-4e8d-ad9a-9147a31e58d3)

38yo F c/o abdominal pain. Orange arrow pointing at anteriorly displaced bladder. Blue arrows pointing at 2 cystic appearing masses in pelvis. Green arrows suggestive of omental primary.](https://app.figure1.com/case-detail/612698ea-196c-42c6-8f72-5d673ed62fa1)

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