For citation purposes: Zibadi S, Sexton WJ, Bui MM, Dhillon J. A large polypoid mass of the bladder: A diagnostic dilemma. OA Case Reports 2014 Jan 18;3(1):2.

Case report


A large polypoid mass of the bladder: A diagnostic dilemma

S Zibadi, WJ Sexton, MM Bui,, J Dhillon,

Authors affiliations

(1) Department of Cell Biology and Pathology, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA

(2) Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA

(3) Department of Anatomic Pathology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA

* Corresponding author



Both neoplastic and non-neoplastic bladder lesions can present as large polypoid masses. Hence, diagnostic biopsy of these lesions becomes imperative to provide valuable information for appropriate therapy. Lesions such as inflammatory myofibroblastic tumour, post-operative spindle cell nodule, sarcomatoid urothelial carcinoma and primary bladder sarcomas may present as polypoid masses. Based on the histological findings, all of these entities may show exuberant spindle cell proliferation. Although, overall histological features in association with immunohistochemical stains may help pathologists to make the correct diagnosis, there are certain pitfalls that warrant caution. We herein present a case that exemplifies this problematic area and highlights the salient histopathologic features and ancillary studies to facilitate the correct diagnosis.

Case Report

We herein report a case of a 71-year-old male who presented with hematuria and on cystoscopy was found to have a large polypoid mass. Histopathologic examination showed a spindle cell lesion.


It is important to carefully examine the spindle cell lesions of the bladder as the differential diagnosis is broad and can range from malignant to benign entities. It is necessary to distinguish these due to therapeutic and prognostic implications.

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