A case of xanthogranulomatous cystitis

Abstract

We report a case of xanthogranulomatous cystitis (XC) in a 76-year-old man who presented with painless hematuria and a bladder mass on imaging studies. Xanthogranuloma is a chronic inflammatory condition that most commonly involves the kidney. XC is a rare condition of still unknown aetiology with only about 20 cases reported to date. The gold standard treatment is surgical resection. Consideration should be given to this entity in the differential diagnosis of urinary bladder masses.

Xanthogranulomatous urethritis and cystitis: a rare clinical and pathological entity

“…It may be associated with the chronic inflammation of the urachal diverticulum [9], with a cyst [3] or with adenoma [6]. Predisposing factors are also a chronic infection induced by the Gram-negative or anaerobic bacteria typical for urinary tract infections [5] or an infection that comes about after tubal ligation [13]. Other causes could be related to a defect in macrophages function [2], abnormal lipid metabolism or an accumulation of lipids in macrophages [12].…”

Xanthogranulomatous Cystitis Presenting as Urinary Incontinence and a Vesicovaginal Fistula: a Case Report and Review of the Literature

“…Some authors have proposed chronic irritation and inflammation of a urachal remnant [2], autoimmune etiology as demonstrated by eosinophilia [5], as well as chronic urinary tract infections and anaerobic infections [6]. Regardless of the true etiology, the ages of patients afflicted with the disease range from 16-80 years of age, and include both males and females in equal distribution [4]. Patients typically present with lower urinary tract symptoms 60% (15/25) of the time and symptoms include frequency, urgency, as well as nocturia.…”

“…Hematuria (microscopic or gross) is present in about a quarter of the patients (6/25), whereas abdominal or pelvic pain is present in 40% (12/25) of patients. Moreover, an abdominal or pelvic mass is identified in 40% (12/25) of patients [3][4][5][6][7][8][9]. Table 1 provides a summary of these statistics.…”

“…Although the kidney is the most common site of xanthogranulomatous disease, there are currently twenty-five previously described cases of this disease reported in the bladder [3]. Most of these cases involve urachal remnants with disease most often isolated to the dome of the bladder [4]. We add our case of XC in an 81 year old female with the unusual initial presentation of urinary incontinence and vesicovaginal fistula (VVF) and provide a brief review of the literature…”

Xanthogranulomatous Prostatitis Presenting as a Prostatic Abscess: Case Report and Review of Literature

“…There are reports of urinary bladder involvement [12] and rare reports of similar lesions affecting corpus cavernosum [13]. Fistula formation has been reported as a complication of xanthogranulomatous inflammation in the kidney [14], as well as after TURP of a previously undiagnosed xanthogranulomatous prostatitis [15].…”