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Inflammatory pseudotumor of urinary bladder
Y J Byun1, B H Chung, K W Kwon
1Department of Urology, Yonsei University College of Medicine, Seoul, Korea.
Insights
A bladder tumor initially suspected as malignant was diagnosed as a benign inflammatory pseudotumor. This finding emphasizes conservative surgical management for inflammatory pseudotumor of the bladder.
Area of Science:
- Uropathology
- Surgical Oncology
Background:
- Bladder tumors present a diagnostic challenge, often requiring differentiation between malignant and benign conditions.
- Grossly protruding intravesical masses necessitate thorough histopathological evaluation.
Observation:
- A 44-year-old male presented with gross hematuria, leading to imaging that revealed a protruding bladder tumor.
- Initial assessment suggested a malignant bladder tumor, prompting transurethral resection.
Findings:
- Histological examination revealed spindle cells in a myxoid stroma, consistent with inflammatory pseudotumor of the bladder.
- This benign entity is characterized by elongated cytoplasm and rare mitotic figures.
Implications:
- Accurate diagnosis of inflammatory pseudotumor is crucial to avoid unnecessary radical surgery.
- Conservative management, such as transurethral resection or partial cystectomy, is recommended for complete excision.
- No metastatic potential has been reported for this benign bladder tumor.
Abstract:
A previously healthy 44-year-old male was admitted with the chief complaint of intermittent gross hematuria. On initial ultrasonographic and CT examination, a grossly protruding intravesical tumor was noted and, under the impression of a malignant bladder tumor, transurethral resection was performed. The histological findings were spindle cells with elongated cytoplasm with rare mitotic figures distributed in myxoid stroma, consistent with diagnosis of inflammatory pseudotumor of the bladder. The benign nature of this tumor warrants conservative surgical management, usually consisting of transurethral resection or partial cystectomy. No reports of metastasis have been reported following complete excision. Therefore, any suspicion and recognition of this entity is imperative to avoid performing an irreversible radical procedure.