Progression of leukoplakia of the bladder to squamous cell carcinoma 19 years after complete urinary diversion

Diffuse Leukoplakia of the Bladder Ostium-Sparing in Patient Treated with Leuprorelin for Breast Cancer

Case

A 55-year-old woman came to our attention in April 2020 referring haematuria, frequency and urgency. The patient referred previous treatment with leuprorelin 3.75 mg/2 ml for breast cancer three years ago. Urine culture was performed and resulted always negative for pathogens. Cystoscopy revealed a whitish plaque lesion on the fundus, dome, trigone, and left lateral wall of the bladder. Histology of the biopsy confirmed the diagnosis of leukoplakia of the bladder. The plan is to follow her up repeating a cystoscopy every three months and biopsy in 6 months. Literature search revealed very little information on pathogenesis and prognosis of this condition due to its rare occurrence. The main objective of our case study was to describe individual situation of a woman affected by diffuse leukoplakia of the bladder ostium-sparing with a previous treatment with leuprorelin 3.75 mg/2 ml for breast cancer and to show safety of follow-up by cystoscopy and biopsy.

Conclusions

We showed a case of a woman treated with leuprorelin and with diffuse leukoplakia of the bladder. We support the recommended long-term follow-up and surveillance based on the literature review by cystoscopy with or without biopsy.

Leukoplakia of the bladder: a case report and literature review

An 81-year-old woman presented with symptoms of recurrent urinary tract infections, urge incontinence and nocturia. Cystoscopy performed revealed a whitish plaque lesion on the fundus and right lateral wall of the bladder. The histology of the biopsy confirmed the diagnosis of leukoplakia vesicae of the bladder. The plan is to follow her up with repeat cystoscopy and biopsy in 6 months. The literature search revealed very little information on the pathogenesis and prognosis of this condition due to its rare occurrence. Analysis of the literature signifies the association of chronic irritation due to recurrent urinary tract infections being the commonest cause of leukoplakia vesicae. The recommended long-term follow-up and surveillance based on the literature review is by cystoscopy with or without biopsy.