A 55-year-old-female Egyptian presented to us with severe dysuria. Laboratory investigations showed high serum creatinine of 3.4 mg/dl. A urinalysis revealed pyuria and hematuria. Liver enzymes were very high due to viral hepatitis and the daily usage of NSAIDs. A KUB showed a large, lamellated, radio-opaque shadow in the pelvis. A non-contrast CT revealed a contracted bladder with diffuse thickening of the bladder wall, and a single, large urinary bladder stone 5 x 6 cm, bilateral marked hydronephrosis, and hepatomegaly. A VCUG showed left reflux grade IV. A cystoscopy confirmed the presence of the stone with multiple biopsies from the erythematous bladder wall. A histopathology showed invasive squamous cell carcinoma. A right percutaneous nephrostomy was inserted with a urethral catheter. There was conservative management for liver disease till the liver functions returned to normal. A radical cystectomy and ileal conduit urinary diversion was performed successfully. The association between a large, neglected bladder stone and SCC should be considered.
Written by:
Hamdy AbdelMawla Aboutaleb, Atef Badawy, Ahmed Gamal-eldin, and Mohammed Badr-Eldin Are you the author?
Reference:
UroToday Int J. 2011 Oct;4(5)
doi: 10.3834/uij.1944-5784.2011.10.8
UroToday.com Renal Cancer Section
