Urothelial carcinoma with squamous differentiation - bladder

Case contributed by Ammar Haouimi
Diagnosis almost certain


Left flank pain with macroscopic hematuria.

Patient Data

Age: 60 years
Gender: Male

Irregular thickening of the left lateral bladder wall with an isodense soft tissue mass with punctate calcification probably within a bladder diverticulum with heterogeneous enhancement infiltrating the perivesical fat and invading the vesicoureteric junction and distal ureter with subsequent ipsilateral uretrohydronephrosis and delayed cortical nephrogram well-visualized on excretory phase. No apparent extension to the seminal vesicles.

No pelvic or para-aortic lymphadenopathy is seen.

No distant abdominal or lung metastasis (CT chest not shown).

Case Discussion

CT features of a heterogeneously enhancing soft tissue mass of the posterolateral bladder wall probably within a diverticulum invading the vesicoureteric junction and distal ureter, histologically confirmed as urothelial carcinoma with squamous differentiation (UCSD) within a bladder diverticulum.

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