Bladder Leiomyoma, Presenting As A Cystitis-Like Syndrome

Abstract

We report a case of a 27-year-old woman with a three-month history of frequency, urgency and mild dysuria interpreted as cystitis. When macroscopic hematuria ensued, an ultrassonography (US) was preformed that revealed a round homogenous mass protruding into the bladder lumen. Magnetic resonance imaging (MRI) showed a pedunculated tumour with the same signal as muscle on T1 weighted and low intensity in T2 weighted sequences. After a transurethral biopsy that showed no malignancy, a transvesical approach was used to resect the tumour. Pathology revealed a bladder leiomyoma. Bladder leiomyomas although rare, are the most frequent benign bladder tumours. The majority of patients report filling symptoms, and a considerable number will also have voiding symptoms that can simulate cystitis. Although bladder masses are an unusual cause of urinary symptoms, in patients with long symptomatic history, this pathology should be discarded.