Squamous cell carcinoma of the bladder mimicking interstitial cystitis and voiding dysfunction

Area of Science:

• Urology
• Oncology
• Pathology

Background:

• Squamous cell carcinoma (SCC) of the bladder is an uncommon bladder cancer subtype (<5% of cases in Western countries).
• SCC typically affects older males and presents with hematuria, often linked to chronic catheter use or spinal cord injuries.
• Interstitial cystitis (IC) shares some symptoms, complicating early SCC diagnosis.

Purpose of the Study:

• To report a rare case of bladder SCC in a young female initially misdiagnosed as IC.
• To emphasize the diagnostic challenges of bladder SCC, particularly when hematuria is absent.
• To review risk factors and typical presentations of bladder SCC and IC.

Main Methods:

• Case report of a 39-year-old female with bladder SCC.
• Review of existing literature on bladder SCC risk factors, symptoms, and differential diagnoses.
• Comparison of presenting symptoms of SCC and IC.

Main Results:

• The patient presented with bladder pain, urinary frequency, and nocturia, without hematuria, leading to an initial IC diagnosis.
• Delayed diagnosis of bladder SCC occurred due to the absence of typical presenting symptoms.
• The case underscores that absence of hematuria should not rule out bladder SCC.

Conclusions:

• Bladder SCC can present atypically, even in younger patients without typical risk factors.
• Diagnostic delays for bladder SCC are possible when classic symptoms like hematuria are absent.
• Clinicians must maintain a high index of suspicion for bladder SCC in patients with persistent urinary symptoms, regardless of hematuria presence.