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Case Reports
. 2014 Oct;6(4):373-5.
doi: 10.4103/0974-7796.141018.

Extensive xanthogranulomatous cystitis mimicking bladder cancer

Amir M Ali  1 , Girish G Nelvigi  1 , Venkatesh Garageshwara Keshavaiah  1 , Chandrashekar S Ratkal  1
Affiliations
Case Reports

Extensive xanthogranulomatous cystitis mimicking bladder cancer

Amir M Ali et al. Urol Ann. 2014 Oct.

Abstract

Xanthogranulomatous cystitis (XC) is a rare benign disease of unknown etiology. A 39-year-old female presented with 2 month history of urgency, dysuria, lower abdominal mass. On physical examination a hard hypogastric mass was present fixed to the rectus muscle. Computerized tomography (CT) abdomen showed heterogeneous enhancing mass arising from the anterior bladder wall with infiltration of the overlying parietal wall. Cystoscopy revealed extensive growth involving the entire wall of the bladder. A biopsy showed cystitis with focal areas suggestive of urothelial neoplasia of unknown malignant potential. Suspecting bladder cancer, we proceeded with radical cystectomy with ileal conduit. Histopathology revealed cystitis cystica with XC of the entire bladder. This is, to our knowledge, the first time that a case has been found to be so extensive with infiltration of the parietal wall and second time that radical cystectomy has been performed for XC.

Keywords: Partial cystectomy; radical cystectomy; urachal remnant; xanthogranulomatous cystitis.

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Conflict of interest statement

Conflict of Interest: None.

Figures

Figure 1
Figure 1
Axial CECT section of the pelvis showing heterogeneously enhancing diffuse wall thickening of the bladder with infiltration of the parietal wall. The arrow shows a well-defined enhancing cystic area in the anterior wall of the bladder
Figure 2
Figure 2
Gross findings revealed thickening of the entire bladder wall extending anteriorly into the posterior rectus sheath. A cystic cavity was seen in the anterior wall of the bladder
Figure 3
Figure 3
Hematoxylin and eosin section; ×10, thin arrow - squamous metaplasia, medium-size arrow-sub-epithelial area with foamy histiocytes, thick arrow-transitional epithelium with inflammatory infiltrate
Figure 4
Figure 4
Hematoxylin and Eosin; ×40, the arrows show foamy histiocytes with abundant clear feathery cytoplasm with nuclei
See this image and copyright information in PMC

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