Abstract : Squamous cell carcinoma (SCC) of the urinary bladder is a rare but aggressive malignancy, accounting for approximately 1-5% of all bladder cancers. It is often associated with chronic irritation, urinary tract infections, and schistosomiasis in endemic areas. Due to its rarity and poor prognosis, SCC of the bladder presents diagnostic and therapeutic challenges. Here, we report a case of a 65-year-old male presenting with hematuria and dysuria, ultimately diagnosed with SCC of the bladder. The patient underwent radical cystectomy with adjuvant chemotherapy. This case highlights the importance of early diagnosis and an aggressive treatment approach to improve outcomes.
Introduction : Squamous cell carcinoma (SCC) of the bladder is an uncommon histological variant of bladder cancer, representing 1-5% of cases worldwide [1-4]. It is strongly associated with chronic inflammatory conditions such as long-term catheterization, recurrent urinary tract infections, and schistosomiasis [5-8]. SCC of the bladder is often diagnosed at an advanced stage, contributing to its poor prognosis.
Case Presentation : A 65-year-old male, chronic smoker, with a history of recurrent urinary tract infections, presented with complaints of gross hematuria and dysuria for six months. Physical examination revealed suprapubic tenderness but no palpable mass. Laboratory investigations showed microscopic hematuria, and urine cytology was inconclusive. Cystoscopy revealed an ulcerated mass on the posterior bladder wall. A transurethral resection of the bladder tumor (TURBT) was performed, and histopathological examination confirmed a diagnosis of squamous cell carcinoma. Imaging studies showed localized disease without distant metastasis.
Management and Outcome:
The patient underwent radical cystectomy with pelvic lymphadenectomy. Postoperative histopathology confirmed muscle-invasive SCC of the bladder (T3N0M0). Given the aggressive nature of SCC, adjuvant chemotherapy with cisplatin-based regimens was initiated. The patient tolerated chemotherapy well and remained under regular follow-up. At six months post-treatment, there was no evidence of recurrence on imaging studies.
Discussion : Bladder SCC is often linked to chronic irritation and inflammation, leading to squamous metaplasia and eventual malignant transformation. Unlike transitional cell carcinoma (TCC), SCC tends to be more invasive at diagnosis and has a worse prognosis. Treatment primarily includes radical cystectomy, with limited response to standard chemotherapy regimens. Early detection remains challenging due to its nonspecific symptoms and low incidence [8-10].
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