Solitary fibrous tumor of the bladder: Diagnostic challenges and surgical management in an elderly male, a case report and literature review

TL;DR

A rare bladder tumor called solitary fibrous tumor in an elderly man was diagnosed and surgically treated, highlighting the need for accurate diagnosis and long-term monitoring.

Contribution

This case report adds to the limited literature on bladder solitary fibrous tumors and emphasizes diagnostic and surgical considerations.

Findings

Bladder SFTs are rare and often misdiagnosed as other spindle cell tumors.

CD34 immunopositivity and histopathology are critical for confirming SFT diagnosis.

Complete surgical excision is essential for favorable outcomes and preventing recurrence.

Abstract

Introduction: Solitary fibrous tumors (SFTs) of the bladder are rare mesenchymal neoplasms that mimic other bladder tumors, requiring a multidisciplinary approach for diagnosis and management.

An 81-year-old male with a 30-pack-year smoking history presented with clotting hematuria and acute renal failure. Imaging revealed a large bladder mass causing bilateral ureteral obstruction. Transurethral resection and immunohistochemical analysis confirmed an SFT. The patient underwent cystoprostatectomy with Bricker diversion, achieving full recovery.

Bladder SFTs are often misdiagnosed as other spindle cell tumors. Histopathology and CD34 immunopositivity are key for diagnosis. Although typically benign, recurrence and metastasis require long-term follow-up.

This case underscores the rarity of bladder SFTs and highlights the importance of accurate diagnosis and complete surgical excision for optimal outcomes.

•Rare presentation: Solitary fibrous tumours (SFTs) of the bladder are rare and mimic other neoplasms, posing diagnostic challenges.•Case description: An 81-year-old smoker had total haematuria and renal failure due to a large bladder SFT causing bilateral ureteral obstruction.•Histopathological diagnosis: Histopathology and CD34-positive immunohistochemistry confirmed the solitary fibrous tumour diagnosis.•Surgical management: Cystoprostatectomy with Bricker diversion was performed due to extensive tumour involvement and urinary obstruction.•Long-term follow-up: Despite a favourable prognosis, regular follow-up is needed to detect recurrence or metastasis.

Rare presentation: Solitary fibrous tumours (SFTs) of the bladder are rare and mimic other neoplasms, posing diagnostic challenges.

Case description: An 81-year-old smoker had total haematuria and renal failure due to a large bladder SFT causing bilateral ureteral obstruction.

Histopathological diagnosis: Histopathology and CD34-positive immunohistochemistry confirmed the solitary fibrous tumour diagnosis.

Surgical management: Cystoprostatectomy with Bricker diversion was performed due to extensive tumour involvement and urinary obstruction.

Long-term follow-up: Despite a favourable prognosis, regular follow-up is needed to detect recurrence or metastasis.

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