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There are four primary types of bladder tumors that can be distinguished on the basis of the appearance (morphology) of the cells under a microscope:

• Transitional cell carcinoma - Also known as urothelial carcinoma, this type of bladder cancer affects the transitional epithelium that lines the wall of the bladder. In the United States, more than 90% of bladder tumors are classified as transitional cell carcinomas.

• Squamous cell carcinoma - This type of bladder cancer represents only about 4% of all bladder tumors and is most commonly associated with chronic irritation of the bladder that can be caused by long-term indwelling bladder catheters or by bladder calculi (stones). Squamous cell carcinoma of the bladder has also been linked to schistosomiasis (a tropical disease spread by parasitic trematode worms) which is endemic in Africa and the Middle East.

• Adenocarcinoma - This is an extremely rare form of bladder cancer accounting for less than 1% of all bladder tumors. It tends to occur in mostly younger patients.

• Small cell carcinoma - This type of bladder cancer is also very rare and represents about 1% of all bladder tumors.