Bladder inflammatory pseudotumour
A bladder inflammatory pseudotumour is a nonneoplastic proliferation of cells.
Epidemiology
This entity is more common in adults, with a mean age at diagnosis of 38 years.
Clinical presentation
Patients present most commonly with an ulcerating bleeding mass, hematuria, and voiding symptoms.
Pathology
Although not neoplastic, the lesions can be locally aggressive and may mimic malignancy clinically, at cystoscopy, and at imaging.
As such, it is critical that the pathologist distinguish inflammatory pseudotumour from rhabdomyosarcoma and myxoid leiomyosarcoma to prevent unnecessary radical surgery.
The pathogenesis of inflammatory pseudotumour remains clear.
Radiographic features
Inflammatory pseudotumours usually appear as a solitary bladder mass, which may be exophytic or polypoid. Ulceration may also be evident.
CT and MRI
On CT and MR images, inflammatory pseudotumours demonstrate enhancement.
Enhancement may be ring like secondary to cellular periphery with a necrotic center.
Treatment and prognosis
Treatment may consist of surgery, a regimen of high-dose steroids, radiation therapy, or conservative management.
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