Large Cystitis Glandularis: A Very Rare cause of Severe Obstructive Urinary Symptoms in an Adult

Severe obstructive symptoms and urinary bladder mass due to cystitis glandularis: A very rare case report in children

Cystitis Glandularis (CG) is an unusual proliferative disease of the bladder. This condition was associated with chronic inflammation or chronic obstruction. This condition usually presents as microscopic finding and the presence of large macroscopic lesion is a rare feature. Until now, the course of disease from transitional to cystitis glandularis is still unclear and the uncertainty of CG to potentially develop into adenocarcinoma has once been documented. Herewith, we report our experience with 2 years old boy with cystitis glandularis presenting with LUTS obstructive symptoms, hematuria and bladder mass. Ultrasound examination revealed bilateral hydronephrosis with hydroureter and bladder wall thickness suggesting the sign of obstruction and chronic inflammation. Cystoscopy examination was performed to ensure the diagnosis with the result revealing protruding mass partially obstructing the bladder trigone, both ureteral orifice and posterior urethra. Transurethral resection was performed and the administration of COX-2 inhibitor and oral steroid therapy were given. Post-operative course was uneventful with the improvement in symptom and uroflowmetry revealed promising result. This case represented an entity of rare and interesting case of cystitis glandularis causing severe obstructive symptoms and urinary bladder mass which appropriate therapy of endoscopic intervention, COX-2 inhibitor and oral steroid resulted in promising outcome. Follow up of 1 year resulted in reduced LUTS symptoms such as straining and difficulty of urination.

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Cystitis Glandularis (CG) is an unusual proliferative disease of the bladder

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This condition is associated with inflammation or chronic obstruction

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Manifestation of large visible macroscopic lesion of the urinary bladder is an extremely rare entity

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Appropriate therapy consisted of endoscopic intervention, COX-2 inhibitor and oral steroid for Cystitis Glandularis resulted in promising outcome.

Cystitis glandularis- rare cause of urinary bladder mass: case report and literature review

Background

Cystitis glandularis a rare benign proliferative disease of the urinary bladder mucosa is usually a microscopic finding and manifests rarely as a large visible macroscopic lesion of urinary bladder. Only few cases of cystitis glandularis presenting as urinary bladder mass in female patients have been reported in the literature. We are reporting a case of cystitis glandularis presenting as a urinary bladder mass in a very young female patient.

Case presentation.

Our patient, a young female 25 years of age presented in the Urology OPD with complaints of irritative lower urinary tract symptoms for two years and intermittent hematuria for one year. On evaluation, she was found to have a urinary bladder mass. Transurethral resection of her urinary bladder mass was done and on histopathological examination, it came out to be cystitis glandularis.

Conclusion

Clinical presentation of cystitis glandularis is variable. It may remain asymptomatic or could present as irritative lower urinary tract symptoms, hematuria, or mucus in the urine. It is normally a microscopic finding but could also present as an overt urinary bladder mass however this has been reported rarely in the literature.

Low-grade mucinous cystic tumor mimicking urinary bladder tumor: imaging-pathologic correlation

Mucin-producing cystitis glandularis is a rare proliferative and metaplastic change of the bladder mucosa that produces large amounts of mucus, thus taking a pseudotumoral pattern and resulting in urinary tract obstruction. We report a case of florid mucin-producing cystitis glandularis mimicking bladder carcinoma in a 77-year-old man that was documented by computed tomography and magnetic resonance imaging. Computed tomography showed diffuse, circumferential, irregular, and lobulated thickening of the bladder wall suggestive of urinary bladder carcinoma. Magnetic resonance imaging showed findings consistent with mucinous content and suggested the correct diagnosis preoperatively.

Acute urinary retention in a patient with extended cystitis glandularis

Cystitis glandularis (CG) is defined as glandular metaplasia of bladder urothelium. In most cases the course of CG is asymptomatic. However, some patients complain of hematuria and lower urinary tract symptoms (LUTS) of varying degrees. We present a case of 45-year-old man with an extensive CG causing acute urinary retention. Although it was initially treated as an infection, prompt ultrasound and cystoscopy helped to establish the diagnosis. Transurethral resection of the cyst with biopsy of the bladder mucosa was then performed. Immediately after surgery the patient noticed significant improvement in urine passing. During the 2-month follow-up there was no relapse.

A case of florid cystitis glandularis

BACKGROUND

A 32-year-old healthy woman from China was diagnosed with a bladder mass during pelvic ultrasonography, carried out during the work-up of a miscarriage. Cystoscopy by the Department of Obstetrics and Gynecology confirmed the presence of a bladder mass, after which she was referred to our department for evaluation and management. The patient was asymptomatic at presentation. She denied urologic symptoms and did not have a history of smoking or industrial exposure to carcinogens.

INVESTIGATIONS

Laboratory test results and urine studies were unremarkable. Cytology revealed benign cells with numerous micro-organisms. Intravenous pyelography revealed a 1 x 2 cm filling defect in the mid posterior bladder compatible with a mass. There were no upper urinary tract defects. We performed cystoscopy with transurethral resection of the bladder tumor.

DIAGNOSIS

Pathology revealed cystitis glandularis.

MANAGEMENT

The patient was followed up with repeat cystoscopy after 4 months; there was no evidence of recurrence. She was scheduled for surveillance after a further 3 months, but was lost to follow-up.