Three cases of pagetoid infiltrations by a transitional cell carcinoma are reported. The theories of histogenesis of extramammary Paget's disease are reviewed and discussed. Evidence from these cases suggests that the lesion develops because of the intraepithelial migration of cells.

No abstract

Plasma and urinary CEA levels in patients presenting with haematuria have been studied to assess whether they facilitate the differentiation between benign and malignant urothelial conditions. Plasma CEA is of no diagnostic value although, if raised, it may suggest an invasive tumour. Urinary CEA levels are only of value in the absence of urinary infection; even then, only 37% of the cases with overt urothelial tumours had raised titres. A knowledge of the urinary CEA level, therefore, would seem to contribute little to the diagnosis of patients presenting with haematuria and all patients must still be investigated by the conventional techniques of urinary bacteriology, cytology, intravenous pyelography and cystourethroscopy.

A 67 year old man presented with haematuria, which on investigation was shown to be derived from a bladder tumour. The tumour initially was a typical transitional cell carcinoma except for rare trophoblastic cells. Over the next year and a half it gradually evolved into a choriocarcinoma. Postmortem examination confirmed that this was a primary choriocarcinoma of the bladder with no other sites of derivation shown.