Inflammatory Pseudotumor: A Rare Cause of Hematuria and Shock

Department of Urology, Dalhousie University Faculty of Medicine, Halifax, Nova Scotia, Canada.
Urology (Impact Factor: 2.19). 09/2007; 70(2):372.e3-6. DOI: 10.1016/j.urology.2007.04.006
Source: PubMed


We report the clinical, radiologic, and pathologic findings of a case of inflammatory pseudotumor in an otherwise healthy 44-year-old woman, who presented with dysuria and hematuria causing hemodynamic instability. Computed tomography revealed a 4.3-cm by 3.5-cm densely enhancing mass arising from the anterior bladder wall. Pathologic examination showed spindle-shaped cells with mild nuclear pleomorphism, rare mitotic activity, and a strong reaction to vimentin, with focal positivity to alpha-actin and S100 protein. Monokeratin, CK7, and CK20 were negative. After two transurethral resections, the patient underwent partial cystectomy.

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    ABSTRACT: Inflammatory pseudotumor of the urinary bladder is a rare reactive proliferation with a clinical presentation similar to malignant neoplasms. We present the case of a 35-year-old woman who presented with left lower quadrant pain and gross hematuria. A diagnosis of cystitis glandularis was initially considered; however, the symptoms did not resolve following transurethral resection. Subsequently, a partial cystectomy was performed after malignancy was excluded based on intraoperative frozen sections. Further histopathological evaluation confirmed the diagnosis of inflammatory pseudotumor.
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    Preview · Article · Mar 2013 · Canadian Urological Association journal = Journal de l'Association des urologues du Canada