Eosinophilic cystitis simulating invasive bladder cancer: a real diagnostic challenge

Abstract

EC is a rare disease. In addition to symptoms of frequency, dysuria, hematuria and suprapubic pain, the disease may present with a bladder mass mimicking invasive bladder cancer. Resection of the lesion is mandatory with systemic treatment of corticosteroids, antihistaminics and antibiotics. Early detection and prompt treatment usually result in a good prognosis.

Eosinophilic cystitis: three cases, and a review over 10 years

“…Finally, a parasitic infection was detected in one patient who was then treated accordingly 8. The most common combination of medications used, were antihistamines with steroids 2 10 11 16 23 27 31 33. Twelve patients (21%) underwent surgery as the only treatment 2 13 30 35 36…”

Presenting manifestations of eosinophilic cystitis in two Filipino children

“…Eosinophilic cystitis (EC) is a rare disorder of the urinary bladder characterized by a transmural involvement of the bladder wall with eosinophils and is thought to be induced by a regulatory disorder of the immune system [3][4][5][6][7]. The pathologic manifestations would range from mild inflammatory cystitis to severe chronic or recurrent relentless inflammation, complete fibrosis of the urinary bladder with secondary involvement of the rest of the urinary tract and obstructive nephropathy with variable degrees of renal insufficiency [3][4][5][6][7][8][9].…”

“…The pathologic manifestations would range from mild inflammatory cystitis to severe chronic or recurrent relentless inflammation, complete fibrosis of the urinary bladder with secondary involvement of the rest of the urinary tract and obstructive nephropathy with variable degrees of renal insufficiency [3][4][5][6][7][8][9].…”

“…Cystoscopic abnormalities comprise a wide spectrum from mucosal erythema to fungating masses. EC cannot be distinguished by cystoscopy from other more common types of benign inflammatory or malignant disease [6]. Children can present with a bladder mass mimicking sarcoma, underscoring the need for biopsy before diagnosis and treatment of a presumed oncological process [3].…”

“…Withdrawal of causative factor or treatment with a drug that may have initiated the allergic reaction has sometimes been followed by resolution of the inflammation. When no obvious cause is identified in EC patients, non-steroidal anti-inflammatory drugs (NSAIDs), anti-histamines, and corticosteroids have been used as the primary management with good results [3][4][5][6][7][8][14][15][16][17][18][19]. These enhance the stability of lysosomal membrane and inhibit formation of immune complexes, thus reducing bladder inflammation.…”