Schistosomiasis and Urothelial Bladder Carcinoma

Abstract

Bladder cancer is the most common malignancy of the urinary tract and it affects four times more men than women. The relationship between bladder tumors and Schistosoma haematobium is well known, but only sporadic cases of bladder infection due to Schistosoma mansoni have been reported. Schistosoma mansoni infection causes an endemic disease in Brazil (schistosomiasis) and gastrointestinal disorders are very common, but disease of the urinary tract is atypical. The aim of this study was to describe a case of a patient presenting schistosomiasis (S. mansoni) and urothelial bladder carcinoma. In this case, a 37-year-old man with intermittent painless gross hematuria was investigated. Cystoscopy revealed a small pedunculated lesion in the bladder dome. Transurethral resection revealed urothelial carcinoma of the bladder, low degree, unrepresentative of the muscular layer of the bladder. After 30 days, a new transurethral resection was performed to sample acquisition of the muscular layer on the basis of the scar. Histopathology was negative for malignancy (Tumor Node Metastasis: TNM-T1). During this procedure, there was evidence of dark rounded lesion in the bladder dome. It was excised and the histopathology showed viable eggs of Schistosoma mansoni. The patient was treated orally with oxamniquine and remained in oncological monitoring with cystoscopy quarterly and serial clinical evaluation. This case reveals a rare finding of Schistosoma mansoni in the bladder and urothelial bladder carcinoma coexisting in the same patient.