Case 2026: Wilma (expert opinion by Thomas Powles)

Wilma, 69 years old, still cooks traditional Dutch meals every Sunday, but she always ends dessert with ‘stroopwafels’ warmed over tea for her grandchildren. She says it is a small tradition that keeps everyone at the table a little longer.

She recently underwent cystoscopy for painless haematuria, revealing a papillary bladder tumour. Her past medical history includes stable coronary artery disease, hypertension and borderline diabetes. She quit smoking 25 years ago.

Assessment summary:

• Diagnostic TURBT, pathological review:
  • At least pT2 urothelial carcinoma (UCa)
  • Unifocal, no concomitant carcinoma in situ (CIS)
• Imaging: suggestive for cT3N0M0
• Ultrasound: no hydronephrosis
• CrCl: 66 ml/min
• No peripheral neuropathy
• No hearing impairment
• ECOG PS: 0
• Cardiac ejection fraction: 62%

The multidisciplinary tumour board assessed that the patient is a candidate for RC + PLND.