Tumor or not?

Leiomyom

i think that could be a tumor. Next things to do a biopsy.
thank you for sharing

DDX Transitional Cell Carcinoma
Biopsy/FNA
Piroxicam

Tumor transicional cel carcinoma. Do not fine needle aspiration biopsy os a better choice

ddx polypoid cystitis
FNA/endoscopic Biopsy, 4-6 weeks on antibiotics

Ddx: neoplasia (TCC, leiomyosarcoma, leiomyoma) vs polypoid cystitis
Further diagnostics: cystoscopy with biopsy, traumatic catheterisation for cytology or surgical biopsy. Plus culture and sensitivity of urine.

There is a mass structure in the urinary bladder. This mass is mild to moderately heterogenous with visible blood flow on Color Flow. The mass appears to arise from the mid region of the urinary bladder wall. There are several polypoid like segments extending off the mass with anechoic centers. The urinary bladder wall appears mildly thickened.

Ddx Inflammatory such as a polypoid cystis vs neoplasia (TCC, leiomyoma etc.)
Further diagnostics
1) A CADET BRAFF can be done on a free catch urine sample as a screening test.
2) FNA is generally not a good option due to the possibility of seeding neoplastic cells if this is a TCC
3) Traumatic catheterization
4) Cystoscopy - my preference
5) Full U/A with sediment (this should be done first)

Thank you for sharing!
Steve

It is certainly suspect for a Tumor. The bladder wall doesn't appear to have extensive changes. The doppler doesn't show as much blood flow as I expected. The rule outs would be a malignancy, benign polyp and large/multiple blood clots. Next steps would be to do complete UA with culture and sensitivity (if growth is present); use appropriate antibiotic; then retest UA and culture to verify clearance of infection and +/- blood presence while still on antibiotics and recheck US to verify the mass lesion's persistence. If the mass is still present surgery would be the next option.

thin peduncle, wall stratification respected, polyp surface relatively smooth and blocky, scarce cystic component.
For me polypoid cystitis ( benign )

Polypoid cystitis seems
more likely than TCC. Cystoscopy should be the best following diagnostic approach in my opinion

Maybe a big clot and polypoid cystitis?

thanks for sharing

Love these videos! Thank you!

Suggestive of bladder tumor

I like the looks of this :) As you scan thru the bladder mass it appears optimistically a good surgical resection and more benign and polypoid with pedunculation rather than a broad wall connection. It is positive for vascularity which is minimal so a clot is ruled out. Due to the large size and minimal wall invasion I personally would go straight to surgery for attempt at resection for palliative improvement and biopsy and culture. If owners on the fence a preop urine culture and BRAF test could be done, but unlikely to resolve with successful antibiotic based on MIC due to large size.

Excellent case! Thanks!!

clot

Beautiful video and captions. Thanks

👍👍

tumor de celulas trancicionales.....

I'd suspect a polyp but cannot be sure without doing either surgery or at least catheterize and aspirate some cells. If it was my own dog I would go directly for surgery (and that is what I would tell the owner.)

blood clot, primary renal hematuria vs coagulopathy vs trauma vs TCC