Perivascular Epithelioid-Cell Tumour of the Bladder: A Case Report

Perivascular epithelioid-cell tumour (PEComa) is a rare mesenchymal tumour with low malignant potential. PEComa can be found in many organs throughout the body. In the urinary system, it can be found in the prostate, bladder, and kidney. Given the rarity of bladder PEComas, a multidisciplinary approach is often required for diagnosis, encompassing radiological imaging, histopathological examination, and immunohistochemical staining.

A 3 cm-diameter mass outside the bladder but related to the anterolateral wall of the bladder was excised by laparoscopic method. A minimally invasive approach was selected to minimise the potential for complications and to preserve bladder function.

The case was diagnosed as PEComa based on the findings of the histopathological examination. Immunohistochemical analysis demonstrated robust positivity for melanocytic and myogenic markers, thereby substantiating the diagnosis. No clear algorithm for disease management was found. However, the patient, who did not have any malignancy criteria specified in literature, was followed up for about 19 months without any problems.

This case highlighted the importance of considering PEComa in the differential diagnosis of bladder masses, even in asymptomatic patients. Further research and case studies are needed to establish a clear management algorithm for PEComa in the urinary system. We present a case of asymptomatic, incidentally detected bladder PEComa in a 27-year-old male patient.