# Aggressive Bladder Urothelial Carcinoma in an HIV‐Positive Male With Neurogenic Bladder Dysfunction due to Spina Bifida: An Autopsy Case

## TL;DR

An HIV-positive man with spina bifida developed aggressive bladder cancer without catheter use, suggesting HIV and neurogenic bladder may contribute to cancer progression.

## Contribution

This case is novel as it links HIV, spina bifida, and aggressive bladder cancer without catheter use.

## Key findings

- The patient had aggressive bladder carcinoma with soft tissue thickening and was diagnosed as cT3N2M1.
- The patient died within 3 months of chemotherapy due to infective endocarditis and cerebral infarction.
- HIV and neurogenic bladder may accelerate bladder cancer progression in young men.

## Abstract

Patients with neurogenic bladder secondary to spinal cord injury are at increased risk of developing bladder urothelial carcinoma due to urinary tract infections. The contribution of HIV infection is unknown in this group of patients.

A spina bifida male patient with macrohematuria and recurrent urinary tract infection was detected with bladder carcinoma covered with soft tissue thickening and was clinically diagnosed cT3N2M1. He was also diagnosed with HIV infection. Despite the treatment with Gemcitabine and Cisplatin, he developed infective endocarditis and a cerebral infarction. He died 3 months after the initiation of chemotherapy.

This case highlights a rare case of aggressive bladder carcinoma developed in an HIV‐positive male with spina bifida, who had never used an indwelling catheter or intermittent catheterization. HIV‐positive men tend to have a higher incidence of bladder cancer at a younger age, and neurogenic bladder might accelerate the progression in this case.