What are the other Names for this Condition? (Also known as/Synonyms)

• High-Grade Noninvasive Papillary Urothelial Carcinoma (HG-NIPUC)
• Noninvasive HG-UrCa
• Noninvasive High-Grade Papillary Urothelial Carcinoma of the Urinary Bladder

What is Noninvasive High-Grade Papillary Urothelial Carcinoma? (Definition/Background Information)

• Noninvasive High-Grade Papillary Urothelial Carcinoma is a very rare form of noninvasive urothelial neoplasm that is diagnosed under the microscope, on examination of the cancer cells by a pathologist. The classification of the tumor is important, as it may dictate the type of treatments to be provided and the overall outcomes
• Noninvasive High-Grade Papillary Urothelial Carcinoma is mostly noted in middle-aged and older adults with average diagnosis age of 70 years; about 75% of the cases are observed in males
• The exact cause of development of this aggressive tumor is presently unknown but is reportedly similar to invasive urothelial carcinomas. It is associated with several genetic alterations, notably TERT promoter gene mutations in between 70-80% of the cases, and mutations involving the FGFR3, TP53, and CDKN2A genes. Occupational exposure to certain chemicals, such as arsenic and organic compounds, and smoking, are also associated risk factors
• Noninvasive High-Grade Papillary Urothelial Carcinomas may be observed anywhere within the urothelial sites but is most commonly seen in the urinary bladder (posterior wall). The most significant presentation of the condition is painless hematuria (blood in urine) that may worsen as the condition progresses. The presence of a large urinary bladder mass may cause obstructive symptoms. Other signs and symptoms include frequent urination urge, urination urgency, and discomfort while urinating. Hydronephrosis or swollen kidney from urine buildup is also observed
• The treatment may include surgery (transurethral resection) followed by immunotherapy with Bacillus Calmette-Guérin (BCG) and chemotherapy using mitomycin C (bifunctional alkylating agent) based on the healthcare provider’s assessment. The prognosis of individuals with Noninvasive High-Grade Papillary Urothelial Carcinoma is generally guarded as it has an aggressive clinical course. Some of the factors that may worsen overall outcomes include higher recurrences, governed by PTEN gene deletions, coexisting low-grade urothelial carcinoma or urothelial carcinoma in situ, high Ki-67 values, mutations on the TP53 and RB genes, and multiple initial tumors
• There is an elevated risk for recurrence of Noninvasive High-Grade Papillary Urothelial Carcinoma following treatment (in about 60% of the cases) and progression of the condition to invasive carcinoma (around 25% of the cases), both of which are higher among women patients