Bladder glandular cystitis causing renal dysfunction: A case report

TL;DR

This case report describes a rare bladder condition called glandular cystitis that caused kidney dysfunction and highlights the importance of accurate diagnosis and long-term monitoring.

Contribution

The paper presents a detailed clinical case of glandular cystitis with renal complications and emphasizes the need for vigilant follow-up to prevent malignant transformation.

Findings

Glandular cystitis was diagnosed via histopathology and confirmed with CK7 and CK20 markers.

The patient showed symptom improvement and no recurrence after three years of follow-up.

Surveillance cystoscopies are recommended due to the risk of malignant transformation.

Abstract

Glandular cystitis is a rare bladder condition with urothelial metaplasia, often linked to chronic irritation and mimicking malignant tumors. Diagnosis is histopathological, utilizing CK7 and CK20 markers. While usually benign, some cases may be associated with carcinoma, requiring long-term surveillance.

Mrs. M, a 68-year-old active smoker, presented with acute oliguria, bilateral flank pain, and other urinary symptoms. Lab results indicated severe acute kidney injury, and a CT scan revealed bilateral hydronephrosis and a 4 cm bladder lesion. After stabilization with hemodialysis, nephrostomies were placed. Two weeks later, transurethral resection showed an atypical bladder lesion, and histopathology confirmed intestinal glandular cystitis. Surveillance cystoscopies were scheduled, with no recurrence at three years. Mrs. M showed significant symptom relief and improved quality of life, as assessed by the FLZM questionnaire.

GC is a rare bladder condition with two forms: glandular (most common) and intestinal metaplasia, which may mimic malignant tumors. Diagnosis relies on cystoscopy, histopathology, and immunohistochemical markers (CK7 and CK20). Non-urological exams, like colonoscopy, rule out systemic involvement. Most cases are benign, but some may be linked to carcinoma in situ or adenocarcinoma. Treatment includes conservative therapies, pharmacologic agents, and transurethral resection for pseudotumoral forms. Fucoidan shows promise as a therapeutic agent. Invasive surgeries like cystectomy or ureteral reimplantation are considered for recurrent cases. Surveillance is necessary due to malignant transformation potential.

GC, though rare, demands early recognition, accurate diagnosis, and tailored management to prevent complications. This case emphasizes the importance of vigilant follow-up and care.

•Glandular cystitis: Rare bladder condition with urothelial metaplasia.•Diagnosis confirmed through histopathology and immunohistochemistry (CK7, CK20).•Conservative and surgical treatments for pseudotumoral forms of GC.•Surveillance needed due to potential malignant transformation.

Glandular cystitis: Rare bladder condition with urothelial metaplasia.

Diagnosis confirmed through histopathology and immunohistochemistry (CK7, CK20).

Conservative and surgical treatments for pseudotumoral forms of GC.

Surveillance needed due to potential malignant transformation.

Figures