Evaluation and management of a patient with a bladder mass of uncertain etiology.

BACKGROUND

A healthy, parous, nonsmoking, 36-year-old woman consulted her gynecologist for nonspecific bladder pain. Urinary tract infection was ruled out. Vaginal ultrasonography and MRI revealed an undefined tumor between the bladder and the uterus. The patient refused further testing until tumor growth was detected at a scheduled appointment 5 months after presentation. She was referred to a urology department at this time.

INVESTIGATIONS: Physical examination, urine culture, medical history, cystoscopy, MRI, angiography, intraoperative frozen section analysis, and final histology.

DIAGNOSIS: Inflammatory myofibroblastic tumor of the bladder. Management Partial cystectomy with complete excision of the tumor from the trigonal and posterior wall of the bladder by median laparotomy.