Transurethral resection of bladder tumour grossing

This article deals with transurethral resection of bladder tumour grossing, also TURBT grossing and TUR specimens.

Introduction

TURBT specimens are common urologic pathology specimens. TURBTs are done for bladder cancer, typically urothelial carcinoma.

Specimen opening

• Not applicable.

Protocol

Specimen:

• Weight ___ grams.
• Dimensions (in aggregate): ___ x ___ x ___ cm.
• Number of fragments: [1-6 / multiple (>6)].
• Appearance: [tan-gray / yellow / orange].
• Consistency: [rubbery / firm].
• Other: [none / hemorrhagic appearance / necrotic appearing].

[Submitted in total/Representative sections submitted] in block(s) ___. †

Notes:

• Recommendations vary on what to do with large TUR specimens - see alternate approaches section.

† Submit 15 blocks for initial assessment - if not muscle invasive: submit more tissue.

Protocol notes

• The European Association of Urology (EAU) recommends submitting separately the exophytic part of the tumour and tumour base in separate containers.
• If the specimen is submitted as per EAU recommendations, representative sampling of the exophytic part and submission of the tumour base in total may be sufficient for staging purposes.^{[citation needed]}

Staging

• Not done at time of gross.

Alternate approaches

Mazzuccheli et al. suggests:

• EIT for TUR specimens up to 10 grams.
• If tumour can be identified at gross: submit 1 block per cm of tumour + some additional tumour if >10 blocks.

University of Chicago suggests:

• Submit in total.

UCLA Health suggests:

• Submit 20 blocks. If tissue remains consult with the pathologist.

See also

• Urothelial carcinoma.

Related protocols

• Partial cystectomy.
• Radical cystectomy.