Case 2024: Friedrich (expert opinion by M. De Santis)

Friedrich, 73 years old, is a true romantic. Almost 50 years ago, he met his wife on one of Vienna’s traditional balls. He remembers being frustrated when his parents forced him to follow dance classes, but he immediately appreciated the good atmosphere and elegant clothes, and soon enough he became a professional in Viennese waltz.

He underwent cystoscopy for painless haematuria, which revealed a papillary tumour.

Assessment summary:

• Medical history: former smoker (40 pack years), hypertension
• ECOG PS: 1
• Maximal TURBT, visually complete
• Pathological review:
  • Minimum T2 UCa
  • Unifocal, no concomitant CIS
• Imaging: suggestive for cT3N0M0
• Ultrasound: no hydronephrosis
• eGFR: 50 ml/min
• No peripheral neuropathy
• No hearing impairment
• Cardiac ejection fraction: 60%
• No voiding symptoms

RC + pelvic lymph node dissection (PLND) is planned.