Inflammatory Myofibroblastic Tumour of the Bladder in a Young Male: A Rare Case Report

Inflammatory myofibroblastic tumour (IMT) of the urinary bladder is a rare mesenchymal neoplasm characterised by spindle-shaped myofibroblastic cells and an accompanying inflammatory infiltrate. Although its aetiology remains unclear, histopathological and immunohistochemical analyses are essential for diagnosis. We report the case of an 18-year-old male who presented with sudden-onset, painless gross haematuria. Initial evaluation revealed severe anaemia, necessitating blood transfusion. Renal ultrasound demonstrated a large echogenic lesion within the bladder. Cystoscopy revealed a large, polypoidal tumour on the right lateral bladder wall with active bleeding. The tumour was completely resected via transurethral resection of bladder tumour (TURBT). Histopathological examination confirmed IMT, with immunohistochemical staining positive for smooth muscle actin (SMA) and anaplastic lymphoma kinase (ALK), supporting the diagnosis. The patient remained stable postoperatively, with no recurrence at three- and six-month follow-up. Bladder IMTs are uncommon, particularly in young males, and typically present with non-specific urinary symptoms, most notably haematuria. Differentiation from other spindle cell neoplasms, including urothelial carcinoma and sarcomas, is crucial for appropriate management. Complete surgical excision is typically curative, and ongoing surveillance with periodic cystoscopy is recommended due to the potential for recurrence. IMT of the bladder is a rare but important differential diagnosis for bladder tumours in young patients presenting with haematuria. Timely diagnosis and surgical intervention can lead to favourable outcomes, underscoring the importance of clinical awareness.