A rare case of aggressive squamous cell carcinoma of the bladder in pregnancy

We report a rare case of an aggressive squamous cell carcinoma of the bladder in a young primigravid woman with recurrent urinary tract infections and microscopic haematuria. An emergency caesarean section was performed at 37 weeks gestation for suspected placental abruption; however, she was found to have frank haematuria. Postnatally, an advanced bladder tumour was diagnosed. She required renal dialysis, a radical cystectomy and radiotherapy but sadly died seven months after diagnosis. This case illustrates the importance of thorough investigation of haematuria in pregnancy. Cystoscopy and even tumour resection can be safely performed in pregnancy. Although squamous cell carcinomas account for only 2% of bladder tumours in developed countries, they tend to be large and deeply invasive, requiring radical surgery and chemotherapy or radiotherapy. Management should be multidisciplinary and treatment individualized due to the significant clinical and emotional challenges which arise when a woman develops a malignancy in pregnancy or the puerperium.