Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2007;30(4):389-91.
doi: 10.1080/10790268.2007.11753958.

Prophylactic radical cystectomy for the management of keratinizing squamous metaplasia of the bladder in a man with tetraplegia

Camilo M Castillo  1 , Chang Y Ha, David R Gater, Baruch M Grob, Adam P Klausner
Affiliations
Case Reports

Prophylactic radical cystectomy for the management of keratinizing squamous metaplasia of the bladder in a man with tetraplegia

Camilo M Castillo et al. J Spinal Cord Med. 2007.

Abstract

Background/objective: To report a case of keratinizing squamous metaplasia of the bladder treated with radical cystectomy.

Design: Case report and discussion of management options.

Methods: Keratinizing squamous metaplasia of the bladder is a rare entity that can result from chronic irritative stimuli involving the bladder. It is considered a premalignant condition associated with invasive squamous cell carcinoma. A case report is presented describing the diagnosis and management of keratinizing squamous metaplasia of the bladder in a tetraplegic man with a chronic indwelling urinary catheter.

Results: Radical cystectomy with an Indiana continent reservoir was performed after cystoscopy with biopsy confirmed keratinizing squamous metaplasia. Final pathology revealed focal erosion and diffuse keratinizing squamous metaplasia of the bladder with prostatic adenocarcinoma as an incidental finding.

Conclusions: Patients with spinal cord injury who use indwelling catheters for bladder management are at higher risk of developing keratinizing squamous metaplasia. Surveillance for early detection of this entity is recommended. Prophylactic cystectomy is sometimes warranted; however, observation and frequent cystoscopic surveillance to identify potential malignant transformation can be an alternative strategy. An interdisciplinary approach is recommended before consideration of bladder resection.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Bladder wall showing flaky, white, plaque-like lesions during cystoscopy (arrow).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Khan MS, Thornhill JA, Gaffney E, Loftus B, Butler MR. Keratinizing squamous metaplasia of the bladder: natural history and rationalization of management based on review of 54 years of experience. Eur Urol. 2002;42:469–474. - PubMed
    1. Stonehill WH, Goldman HB, Dmochowski RR. The use of urine cytology for the diagnosing bladder cancer in spinal cord injured patients. J Urol. 1997;157:2112–2114. - PubMed
    1. Ozbey, Aksoy Y, Polat O, Bicgi O, Demirel A. Squamous metaplasia of the bladder: findings in 14 patients and review of the literature. Int J Nephrol. 1999;31:457–461. - PubMed
    1. Guo CC, Fine SW, Epstein JI. Noninvasive squamous lesions in the urinary bladder: a clinicopathologic analysis of 29 cases. Am J Surg Pathol. 2006;30:883–891. - PubMed
    1. Kuruvilla S, Ramakrishna B, Nath V. Keratinising squamous metaplasia of the urinary bladder. Indian J Pathol Microbiol. 1994;37:S39–40. - PubMed

Publication types