Open Access

RESIDENT’S CORNER

A case of severe bladder wall hypertrophy: bladder cancer or sequela of bladder outlet obstruction?

Mark Tyson¹, Margaret French^1,4, Nancy McNulty^1,3, Lori Lerner^1,2

1 Dartmouth Medical School, Hanover, New Hampshire, USA
2 Section of Urology, White River Junction VA, White River Junction, Vermont, USA
3 Department of Radiology, White River Junction VA, White River Junction, Vermont, USA
4 Department of Pathology, White River Junction VA, White River Junction, Vermont, USA
Address correspondence to Mark Tyson, Dartmouth Medical School, Kellogg 135, Hanover, New Hampshire 03755 USA

Canadian Journal of Urology 2009, 16(1), 4516-4518.

Abstract

Angiosarcomas are soft tissue malignancies of connective tissue origin with rapid hematogenous spread, but are extremely uncommon primary tumors of the bladder with approximately ten reported cases in the 20th century. We report a 59-year-old man with benign prostatic hyperplasia (BPH) and gross hematuria who underwent a bladder biopsy for a markedly thickened bladder wall on CT scan. Biopsy specimens demonstrated deep vascular malformations that were concerning for a malignancy. Intense pathological review was initially not defi nitive and transurethral resection of the prostate (TURP) was performed for his symptoms. Interestingly, surgery reversed the bladder process. This case serves as a unique example of how the sequelae of bladder outlet obstruction (BOO) can resemble a malignant process on presentation but represent no more than hypertrophic adaptations in the bladder wall musculature of a patient with BPH and signifi cant outlet obstruction.

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