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Aim:Histopathological classification is one of the main prognostic factors for non-muscle invasive bladder tumors (NMIBT). We evaluated the relationship between tumor progression and the ratio of high-grade differentiation plus other routine pathological parameters in NMIBT.Materials and Methods:Ninety-two patients diagnosed with high grade NIMBT were analyzed between 2010-2018. Demographic information, tumor size, localization, multicentricity, and recurrence/progression situation were evaluated retrospectively. The high/low grade percentage ratio of tumor cells, tumor stage, differentiation, necrosis, lamina-propria invasion, lymphovascular invasion, and carcinoma in-situ presence were also examined by two uro-pathologist. The effect on tumor progression was evaluated with pathological findings.Results:Seventy-four (80.4%) of the patients were reported as T1 and 18 (19.6%) as Ta. The mean ratio of high-grade findings was 11.9±8.5% and 69.5±28.1% for Ta and T1 patients, respectively(p25%, >50% and >75% was found to be 67(72.8%), 54(58.7%) and 43(46.7%), respectively. The high-grade ratio for >25% was in only 1 Ta patient while it was in 66 of the T1 patients(p75%(p50%(p=0.025).Conclusion:When evaluating the nuclear grade, defining tumors solely as high-grade leads to stratifying a highly heterogeneous population in a single group. Higher rate of progression is observed in NIMBT patients with high-grade ratio >50%.

Renal cell carcinoma is an aggressive tumor that accounts for 3% of adult neoplasia. The most common sites of metastasis are the lung, adrenal, large intestine, brain and intraabdominal organs. In addition, cases of metastasis in the heart, bladder, breast, tonsil and thyroid have been reported in the literature. We present a case of renal cell carcinoma metastasis located in a nasal cavity in order to emphasize the possibility of metastatic lesions being responsible for nasal obstruction and epistaxis.