Urothelial carcinoma is the sixth most common malignancy in the US with estimated 81,190 new cases and 17,240 deaths respectively for 2018. The prognosis of bladder cancer remains poor and worsens when tumor becomes muscle invasive (1). Transitional cell carcinoma is the most common bladder cancer histology, accounting for more than 90%, whereas other histologies account for no more than 2–3% per variant (2).