Abstract

Introduction: Benign bladder tumors are rare in adults and are often misdiagnosed as malignant lesions even by experienced urologists and pathologists. Inflammatuar myofibroblastic pseudotumors are characterized by spindle cells, myofibroblastic and fibroblastic proliferation with a prominent inflammmatory cell infiltration. Despite their benign behaviour, they are frequently misinterpreted as leiomyosarcomas and rhabdomyosarcomas in preoperative biopsies.

Materials and Methods: In this report, we describe two cases with inflammatory pseudotumors of the bladder. A 26-year old woman presented with vaginal bleeding and macroscopic hematuria and a 26 year old man presented with gross macroscopic hematuria. Imaging studies revealed large polypoid filling defects in the bladder lumen in both cases. Cystoscopic examination and transurethral tumor resection were performed. The male patient was treated with transurethral resection at the time of the confirmatory cystoscopy and the other with an endoscopically unresectable tumor, which revealed benign non-epithelial tumor, was treated with partial cystectomy.

Results: Histopathological examinations of the tumors revealed inflammatuar pseudotumor. Since all bladder inflammatory pseudotumors reported to date have been benign, no additional treatment was done. The patients follow up time are 10 years for the one who was treated with transurethral resection and 12 months for the other patient who was treated with partial cystectomy.

Conclusion: Differentiating these tumors from malignant lesions may be difficult but it has important consequences for therapy. The goal of treatment is tumor resection with the preservation of the bladder in these kinds of tumors.