A 43-year-old woman and a 73-year-old man were referred separately from primary care to the urology service with short histories of frank haematuria. In both cases, histology from transurethral resection of their bladder tumours demonstrated the rare clear cell variant of urothelial/transitional cell carcinoma. Staging scans found the former patient had low-volume local disease, and the latter had locally advanced disease. The former patient went on to have partial cystectomy and pelvic lymph node dissection (with the endoscopic portion of the partial cystectomy undertaken by holmium:YAG laser), while the latter was found to have inoperable disease, and proceeded to chemotherapy. The former patient was alive with no evidence of disease recurrence at 45 months, while the latter was alive but with extensive lymph nodal recurrence at 45 months.

BMJ case reports. 2019 Jun 16*** epublish ***

James P Blackmur, Nadja Melquiot, Katherine E Robertson, Seamus Teahan

MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK., Histopathology Department, NHS Forth Valley, Larbert, UK., Urology Department, NHS Forth Valley, Larbert, UK.