Behind the Smoke: A Bladder Cancer Case Report Through the Eyes of Primary Care.

Bladder carcinoma represents a common neoplasm in men, typically presenting with hematuria or as an incidental finding. Smoking and occupational exposure are its main risk factors. Currently, no screening method is available for its detection. We present the case of a 69-year-old retired man (former car mechanic), with a history of hypertension, dyslipidemia, and type 2 diabetes mellitus, who attended a routine appointment at his primary healthcare center, with no complaints. In addition to standard tests, an abdominal ultrasound was requested to screen for abdominal aneurysm, in accordance with established guidelines, as the patient was a heavy smoker. Three weeks later, he returned with his test results, identifying two suspicious polypoid formations in the bladder. He was referred to a urology consultation, where he underwent a transurethral resection of the bladder tumor. Posterior examination identified two carcinomas, requiring chemotherapy for one year. This case describes an asymptomatic patient with risk factors for bladder cancer who was diagnosed incidentally, emphasizing the need for their careful management, a crucial role played by family physicians.