Bladder inflammatory pseudotumor

Last revised by Ammar Haouimi on 1 Dec 2020

Bladder inflammatory pseudotumor is a non-neoplastic proliferation of cells.

This entity is more common in adults, with a mean age at diagnosis of 38 years. 

Patients present most commonly with an ulcerating bleeding mass, hematuria, and voiding symptoms.

Although not neoplastic, the lesions can be locally aggressive and may mimic malignancy clinically, at cystoscopy, and at imaging. 

As such, it is critical that the pathologist distinguishes inflammatory pseudotumor from rhabdomyosarcoma and myxoid leiomyosarcoma to prevent unnecessary radical surgery.

The pathogenesis of inflammatory pseudotumor remains unclear.

Inflammatory pseudotumors usually appear as a solitary bladder mass, which may be exophytic or polypoid. Ulceration may also be evident. 

On CT and MR images, inflammatory pseudotumors demonstrate enhancement.

Enhancement may be ring-like secondary to the cellular periphery with a necrotic center.

Treatment may consist of surgery, a regimen of high-dose steroids, radiation therapy, or conservative management.

Please refer to our article on bladder wall thickening for specific discussion.

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