<s>[INST] Hello doctor, This is the biopsy test report of my father which we received today. Please suggest what treatment should be done.  Clinical findings: Multiple papillary tumors in the bladder. Clinical diagnosis: T.C.C urinary bladder. Tissue forwarded: TURBT. Macroscopy: Gray white tissue bit together (M)2 .5CM(AE). Microscopy: The sections show neoplasm arising from the transitional cells and still recognizable of transitional origin. The number of cell layers are increased, more than ten mitosis present. Loss of polarity seen variable in cell size, shape, and chromaticity seen. Diagnosis: Grade II , Transitional cell carcinoma, urinary bladder. [/INST] Hello. The report is showing transitional cell carcinoma (TCC) of the urinary bladder (cancer of urinary bladder). In biopsy report, there is no comment on muscle involvement. That means we need to know whether the tumor is superficial or deep (involving muscle) also. They need to comment on the biopsy report on muscle involvement, whether involved or not or maybe the surgeon did not take muscle biopsy. In that case, they have to do cystoscopy again. Because treatment and diagnostic workup is different for superficial and deep (muscle invasive tumor). If superficial only, then simple surgery through cystoscopy to remove superficial tumors called TURBT surgery. After that, they may give weekly intrabladder BCG or chemo to prevent recurrence. Superficial urinary bladder tumor (TCC) is highly curable. But if the muscle is involved, then he must undergo further investigations like CT scan chest and abdomen, isotope bone scan and MRI pelvis to rule out the distant and local spread. After staging workup he will be planned for management, that is, surgical removal of bladder plus chemotherapy. If you have it, upload cystoscopy report also. For more information consult a medical oncologist online --> </s>