A high suspicion patient


  • Male, 48 years old
  • Recently gave up smoking (previously 20 cigarettes a day)

Symptoms / reasons for consultation

  • Intermittent painless hematuria for past 6 months
  • The patient suspected bladder cancer and was concerned


  • Two urinary cytology’s were suspicious, but inconclusive
  • Flexible white light cystoscopy revealed a papillary tumor overlying the left ureteric orifice
  • The patient was referred to a transurethral resection of the bladder (TURBT)

Initial resection

  • Hexvix® blue-light cystoscopy was performed
  • A papillary tumor was resected
  • Fluorescent patch suspect for carcinoma in situ was identified and resected


Histological results

  • Low-grade TaG2 tumor with dysplastic lesions in surrounding area
  • CIS lesion completely resected

Post-Operative treatment

  • One immediate instillation of Mitomycin C followed by 1 year of BCG instillation
  • Patient was then followed up with flexible cystoscopies and cytologies with no recurrence and no complications