Extensive xanthogranulomatous cystitis mimicking bladder cancer

Area of Science:

• Urology
• Pathology

Background:

• Xanthogranulomatous cystitis (XC) is a rare, benign bladder disease with an unknown cause.
• It presents with symptoms like urgency, painful urination, and a palpable abdominal mass.

Observation:

• A 39-year-old female presented with a 2-month history of lower urinary tract symptoms and a hypogastric mass.
• Imaging revealed a heterogeneous mass on the anterior bladder wall infiltrating the parietal wall.
• Cystoscopy showed extensive bladder wall involvement.

Findings:

• Initial biopsy suggested urothelial neoplasia of unknown malignant potential, leading to suspicion of bladder cancer.
• Histopathology confirmed extensive xanthogranulomatous cystitis involving the entire bladder.
• This represents the most extensive XC case reported, infiltrating the parietal wall.

Implications:

• Radical cystectomy with ileal conduit was performed due to the extensive nature of the disease.
• This case highlights the importance of considering rare diagnoses even with concerning initial findings.
• Further research into the etiology and optimal management of extensive XC is warranted.