A case report of usual presentation of unusual bladder mass-polypoid cystitis in a young Indian female

Introduction and importance: Polypoid cystitis is a rare benign exophytic lesion affecting the bladder mucosa that clinically and radiologically resembles urothelial carcinoma. An adequate diagnosis of this pathology requires histological evaluation. Owing to the rare occurrence of this benign urinary bladder lesion, its prevalence is under-reported, with very few cases reported.

Case presentation: Here, we report a case of polypoid cystitis in a young Indian female, who presented to the urology department with obstructive LUTS and a history of catheterization for urinary retention. The patient was evaluated and found to have a usual bladder mass that was clinically and radiologically suspected to be a carcinoma bladder, so TURBT of the mass was performed. The mass was completely resected and sent for HPE, which revealed features of polypoid cystitis.

Clinical discussion: Polypoid cystitis should be considered in the differential diagnosis of urinary bladder masses presenting at a younger age with a history of dysuria, LUTS, multiple catheterizations for retention of urine along with no history of hematuria and negative familial history for carcinoma. One of the common factors in all cases of polypoid cystitis is a history of long-standing catheterization, which might predispose patients to such a benign lesion or vice versa. Adequate histopathological evaluation of these benign lesions is crucial for accurate diagnosis.

Conclusion: Therefore, in young female/males without a familial history of bladder carcinoma or environmental carcinogen exposure, benign bladder lesions should be suspected first rather than malignant lesions, although malignant lesions of the bladder are far more common than benign lesions.