Gupta Sajal, Adiga K Prashanth, Raj K Kishan, Bhat Nandakishore
Department of Urology & Renal Transplantation, Father Muller Medical College, Mangalore, Karnataka 575002, India.
Department of Urology & Renal Transplantation, Father Muller Medical College, Mangalore, Karnataka 575002, India.
Int J Surg Case Rep. 2024 Dec;125:110640. doi: 10.1016/j.ijscr.2024.110640. Epub 2024 Nov 22.
Polypoid cystitis is a rare benign exophytic lesion affecting the bladder mucosa that clinically and radiologically resembles urothelial carcinoma. An adequate diagnosis of this pathology requires histological evaluation. Owing to the rare occurrence of this benign urinary bladder lesion, its prevalence is under-reported, with very few cases reported.
Here, we report a case of polypoid cystitis in a young Indian female, who presented to the urology department with obstructive LUTS and a history of catheterization for urinary retention. The patient was evaluated and found to have a usual bladder mass that was clinically and radiologically suspected to be a carcinoma bladder, so TURBT of the mass was performed. The mass was completely resected and sent for HPE, which revealed features of polypoid cystitis.
Polypoid cystitis should be considered in the differential diagnosis of urinary bladder masses presenting at a younger age with a history of dysuria, LUTS, multiple catheterizations for retention of urine along with no history of hematuria and negative familial history for carcinoma. One of the common factors in all cases of polypoid cystitis is a history of long-standing catheterization, which might predispose patients to such a benign lesion or vice versa. Adequate histopathological evaluation of these benign lesions is crucial for accurate diagnosis.
Therefore, in young female/males without a familial history of bladder carcinoma or environmental carcinogen exposure, benign bladder lesions should be suspected first rather than malignant lesions, although malignant lesions of the bladder are far more common than benign lesions.
息肉样膀胱炎是一种罕见的良性外生性病变,累及膀胱黏膜,在临床和影像学上与尿路上皮癌相似。对这种病理状况进行充分诊断需要组织学评估。由于这种良性膀胱病变罕见,其患病率报告不足,仅有极少病例被报道。
在此,我们报告一例年轻印度女性的息肉样膀胱炎病例,该患者因下尿路梗阻症状就诊于泌尿外科,并有因尿潴留进行导尿的病史。对患者进行评估后发现其膀胱有一个常见肿物,临床和影像学检查怀疑为膀胱癌,因此对该肿物进行了经尿道膀胱肿瘤切除术(TURBT)。肿物被完整切除并送去做苏木精-伊红染色病理检查(HPE),结果显示为息肉样膀胱炎的特征。
对于年龄较轻、有排尿困难、下尿路梗阻症状、多次因尿潴留进行导尿、无血尿病史且无膀胱癌家族史的膀胱肿物患者,鉴别诊断时应考虑息肉样膀胱炎。息肉样膀胱炎所有病例的一个常见因素是长期导尿史,这可能使患者易患这种良性病变,反之亦然。对这些良性病变进行充分的组织病理学评估对于准确诊断至关重要。
因此,在无膀胱癌家族史或无环境致癌物暴露史的年轻女性/男性中,尽管膀胱恶性病变远比良性病变常见,但应首先怀疑为良性膀胱病变而非恶性病变。