Bladder inflammatory pseudotumor is a non-neoplastic proliferation of cells.
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Epidemiology
This entity is more common in adults, with a mean age at diagnosis of 38 years.
Clinical presentation
Patients present most commonly with an ulcerating bleeding mass, hematuria, and voiding symptoms.
Pathology
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.
Radiographic features
Inflammatory pseudotumors usually appear as a solitary bladder mass, which may be exophytic or polypoid. Ulceration may also be evident.
CT and MRI
On CT and MR images, inflammatory pseudotumors demonstrate enhancement.
Enhancement may be ring-like secondary to the cellular periphery with a necrotic center.
Treatment and prognosis
Treatment may consist of surgery, a regimen of high-dose steroids, radiation therapy, or conservative management.
Differential diagnosis
Please refer to our article on bladder wall thickening for specific discussion.