Bladder Endometriosis Mimicking TCC - A Case Report

Abstract

Endometriosis is the ectopic presence of endometrial tissue outside the uterus. Though on its own endometriosis is not a rare lesion, the involvement of the urinary tract is rare but with the bladder being the most commonly affected organ. Endometriosis is usually seen in females between the ages of 30-40 years and may occur due to fluctuating levels of oestrogen and progesterone. Clinically the patient maybe asymptomatic or show symptoms of dysmenorrhea, irregular or heavy periods, pain in the pelvic area, lower abdomen or in the back. It has been suggested that ultrasonography should be done either before or during menstruation as the lesion becomes more evident and a biopsy taken during this period is a strong aid in reaching a final diagnosis. We report here an unusual case of bladder endometriosis where the patient came with severe pelvic pain and an endoluminal mass seen on the ultrasonographic report. Based on these findings a differential of transitional cell carcinoma was given which was ruled out based on the cystoscopic findings.

Keywords: Cystoscopy; Endometrial tissue; Transitional cell carcinoma; Urinary system.

[Table/Fig-1]:

CeCT image showing an enplaque soft tissue mass arising from the posterior wall of the urinary bladder (arrow), sagittal section.

[Table/Fig-2]:

CeCT image showing an enplaque soft tissue mass arising from the posterior wall of the urinary bladder (arrow), transverse section.

[Table/Fig-3]:

Elevated lesion in the posterior wall of the bladder with a blue-black cystic base. With extravasation of jelly like material (arrow) from the cyst.