Urethral stone and urinary squamous cell carcinoma

Case contributed by Dr Ahmed Abd Rabou

Presentation

Dysuria and loin/flank pain of several months duration

Patient Data

Age: 70-75Y
Gender: Male
Modality: Fluoroscopy

Plain film and contrast study (MCUG and ascending urethrogram) reveal a large oval shape stone at the posterior urethra which causes incomplete obstruction. Associated dilatation of proximal posterior urethra, irregular urinary bladder wall especially the anterior wall and vesicoureteric reflux.

Modality: Fluoroscopy

Plain film and contrast study (MCUG and ascending urethrogram) reveal a large oval shape stone at the posterior urethra which causes incomplete obstruction. Associated dilatation of proximal posterior urethra, irregular urinary bladder wall, especially the anterior wall and vesicoureteric reflux.

Modality: Ultrasound

Pelvic ultrasonography reveals reduced capacity urinary bladder with an ill defined anterior wall due to the presence of an ill defined infiltrative mainly extraluminal mass with abnormal vascularity on Doppler US.

Noncontrast CT of the abdomen and pelvis reveals left aspect of anterior wall of urinary bladder mural mass with small irregular intraluminal portion and large infiltrating extra vesical portion that infiltrate the adjacent fat and reaches and infiltrates the left rectus abdominus muscle. 

The CT confirms the stone adjacent to the urethra.

Diagnosis: Urethral stone complicated by cystitis and urinary bladder squamous cell carcinoma (pathology proved)

Case Discussion

The patient has a stone in the posterior urethra, compatible with calcification in a diverticulum. It resulted in incomplete obstruction and vesicoureteric reflux. This also caused chronic irritation to urinary bladder mucosa and bladder stones are associated with induced squamous cell metaplasia and carcinoma

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Case Information

rID: 22955
Case created: 7th May 2013
Last edited: 5th Dec 2015
System: Urogenital
Inclusion in quiz mode: Included

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