1. Case 6

2. Basic clinical data Archive case of I. Alvarado-Cabrero (Centro Medico, Mexico City) Archive case of I. Alvarado-Cabrero (Centro Medico, Mexico City) Hispanic male, 65 years Hispanic male, 65 years Tumor of the urinary bladder Tumor of the urinary bladder TRUS with subsequent cystectomy TRUS with subsequent cystectomy

3. Your opinion, diagnosis?

4. Scorpio Euscorpius spec

5. Micropapillary urothelial carcinoma cca 95 cases were published cca 95 cases were published Amin et al:Micropapillary variant of transitional cell carcinoma of the urinary bladder. Histologic pattern resembling ovarian papillary serous carcinoma. Am J Surg Pathol 18, 1994, 1224- 1232 Amin et al:Micropapillary variant of transitional cell carcinoma of the urinary bladder. Histologic pattern resembling ovarian papillary serous carcinoma. Am J Surg Pathol 18, 1994, 1224- 1232 WHO 2004-variant of TCC WHO 2004-variant of TCC

6. Basic clinico-pathologic features of micropapillary transitional cell carcinoma Main age: 66 years Main age: 66 years Male prevalence Male prevalence Vascular invasion is usually present in time of diagnosis Vascular invasion is usually present in time of diagnosis Usually high-grade tumors Usually high-grade tumors EMA/CK 7 usually positive EMA/CK 7 usually positive High stage in time of diagnosis, very bad prognosis (up to 12 months after establishing of the diagnosis) High stage in time of diagnosis, very bad prognosis (up to 12 months after establishing of the diagnosis)

7. Differential diagnostics High-grade „classic“ TCC High-grade „classic“ TCC Inverted papilloma Inverted papilloma „Nested“ variant of TCC „Nested“ variant of TCC

8. Micropapilary ca vs. inverted papilloma

9. Micropapillary ca-variants

11. Micropapilary ca vs. inverted papilloma