Muscle invasive bladder cancer presenting as recurrent autonomic dysreflexia - a wolf in wolf's clothing.

Context: Autonomic dysreflexia is a potentially lethal condition experienced by spinal cord injury (SCI) patients. It has a wide range of causes, most of which are genitourinary in nature. However, there has been no documented case of primary bladder cancer as a trigger for recurrent autonomic dysreflexia. Findings: We present a case of a 51-year-old spinal cord injury patient with multiple presentations of autonomic dysreflexia. Work up revealed locally invasive bladder cancer, and following definitive surgery, his symptoms were alleviated.

Conclusions

In SCI patients with recurrent AD, comprehensive work up with involvement of a specialized Urologist is required as AD may be the only presenting symptom of a serious underlying medical condition.