Abstract
Squamous cell carcinoma (SCC) of the bladder is a relatively uncommon cause of bladder cancer accounting for <5% of bladder tumors in the western countries. SCC has a slight male predominance and tends to occur in the seventh decade of life. The main presenting symptom of SCC is hematuria, and development of this tumor in the western world is associated most closely with chronic indwelling catheters and spinal cord injuries. A 39-year-old Caucasian female presented with bladder and lower abdominal pain, urinary frequency, and nocturia which was originally believed to be interstitial cystitis (IC) but was later diagnosed as SCC of the bladder. Presentation of SCC without hematuria is an uncommon presentation, but the absence of this symptom should not lead a practitioner to exclude the diagnosis of SCC. This case is being reported in an attempt to explain the delay and difficulty of diagnosis. Background on the risk factors for SCC of the bladder and the typical presenting symptoms of bladder SCC and IC are also reviewed.
Highlights
In western regions, primary Squamous cell carcinoma (SCC) of the bladder is uncommon with an incidence of 1.2–4.5% of all vesical tumors [1,2,3,4,5,6]
In a case series documented by Pattison et al, the presenting symptoms of four patients with SCC of the bladder included microscopic hematuria, suprapubic pain, and continuing urinary tract infections (UTIs) [16]
A case reported by Zaidi et al described a woman who was diagnosed with bladder SCC following investigation of hematuria [11]
Summary
Primary SCC of the bladder is uncommon with an incidence of 1.2–4.5% of all vesical tumors [1,2,3,4,5,6]. In contrast to bladder SCC, IC sufferers tend to be female and predominantly middle-aged [13]. Presenting symptoms consist of subacute development of pain on bladder filling, urinary frequency unrelieved at night, urgency, and frequency of micturition [13, 14]. When present in male patients, the most common symptoms are analogous to those in females. These include suprapubic pain, urinary frequency, and dysuria [15]
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