Does Variant Histology Change Management of Non-muscle-invasive Bladder Cancer?

Maximilian Burger, Ashish M. Kamat, David McConkey

Research output: Contribution to journalArticlepeer-review


A 52-yr-old man, 35 pack-year smoker, is diagnosed with two non-muscle-invasive urothelial tumors, pTa and pT1, the former upstaged to pT1 by a reference pathologist. Two possible treatment strategies include intravesical bacillus Calmette-Guérin (BCG) and/or primary or rescue cystectomy. The importance or even accurate existence of “variant histology” is put into perspective, and whether the reference pathologist's diagnosis of a micropapillary variant requires a real change in treatment strategy is considered. Patient summary: The reference urologist diagnosed two small bladder tumors as two different depths of infiltration: one as pTa and the other (slightly more severe) as pT1. Suspecting a variant, the reference urologist referred to a second pathologist, who upstaged the less severe tumor to T1, with both defined as micropapillary cancer. This presentation discusses removal of the bladder versus a trial of treatment with bladder preservation.

Original languageEnglish (US)
Pages (from-to)510-514
Number of pages5
JournalEuropean Urology Oncology
Issue number3
StatePublished - Jun 2021


  • Bacillus Calmette-Guérin
  • ERBB2
  • HER2
  • Micropapillary differentiation
  • Radical cystectomy
  • Variant histology

ASJC Scopus subject areas

  • Medicine(all)


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