Xanthogranulomatous Cystitis Arising from the Posterior Wall of the Bladder

Abstract

Xanthogranulomatous cystitis is a rare, benign chronic inflammatory disease of unknown etiology. Herein we report a case of a 41-year-old man who presented with painless hematuria and a bladder mass on imaging studies.

Xanthogranulomatous Cystitis Treated by Transurethral Resection

“… 1 Since the first report by Wassiljew in 1932, 2 27 cases of XC have been reported in the literature. All 28 cases, including the present report, had the following clinical characteristics 1 , 2 , 3 , 4 , 5 ( Table 1 ): a median age of 46 years (range, 16–76 years) and no sexual predominance (14 cases in males, 13 cases in females, and one unknown).…”

“…In the previously reported cases, the proposed etiology includes an urachal remnant, a chronic infection, foreign materials such as retained suture materials, a malignant bladder tumor, immunological disorders, abnormal lipid metabolism, and urethral stenosis. 1 , 3 , 4 , 5 In the kidney, xanthogranulomatous inflammation always develops as a consequence of an infection, which is often associated with urinary obstruction. In the present case, the XC may have been caused by repeated cystitis or retained suture materials.…”

“…Of the 28 published cases, the treatment measure was partial resection in 22 cases, transurethral resection in four cases including the present case, total cystectomy in one case, and augmentation cystoplasty for a small capacity bladder after the exclusion of neoplasm in one case. The use of transurethral resection to treat XC was reported only in recent years, 5 possibly because of early detection via imaging tests. Transurethral resection appears to be a minimally invasive and curative treatment for small XC lesions.…”

Pediatric Xanthogranulomatous Cystitis

“…4 In the 8 cases reported since that time, 50% were located in the dome, and none reported association with a urachal anomaly. 1,2,[5][6][7][8][9][10] Of note, there have been 2 patients with XC reported with simultaneous urachal adenocarcinoma and 1 with upper tract urothelial carcinoma. 3,4 XC has been described in a patient with foreign material in the bladder 1 and in 3 patients with a history of inflammatory bowel disease.…”

Xanthogranulomatous cystitis with malacoplakia, leading to spontaneous intraperitoneal perforation of the urinary bladder in a 9-year-old girl

“…XC is an extremely rare, chronic inflammatory disorder found throughout the world, and approximately 30 cases have been reported since the first report in 1932 by Wassilijew 9 10. XC could possibly be a chronic inflammatory process caused by an immunological defect of the macrophage,11 chronic infection with gram negative or anaerobic bacteria such as encountered in urinary tract infections or in foreign material, such as retained suture material, and abnormal lipid metabolism 12 13…”