Silent danger uncovered: Early detection of urinary bladder tumour during routine health screening—a case study

Jeeva Rima. S1, Sreeharsha2, Mohan & Team3

1Department of Family Medicine, Kauvery Hospital, Electronic City, Bengaluru

2,3Department of Urology, Kauvery Hospital, Electronic City, Bengaluru

Abstract

Early detection of asymptomatic urinary bladder tumours is rare due to the silent progression of the disease. This case study presents a patient diagnosed with an early-stage bladder tumour during a routine health check-up, highlighting the importance of preventive screenings. Timely intervention allowed for successful treatment, underscoring the value of vigilance even in the absence of symptoms.

Introduction

Urinary bladder cancer often presents late due to subtle or absent symptoms. Early detection is important as it improves prognosis and reduces morbidity.

Objective

To highlight a case where a tumour was identified during routine health screening.

Case Presentation

A 45-year-old male, a U.S citizen residing in India for two years., who was asymptomatic, came for a routine health check-up.

On examination, vitals were normal. General and systemic examination were also normal. Routine screening lab investigations was normal.

Urine routine was normal.

Ultrasound abdomen showed an echogenic mass – 0.7 cm in the bladder.

He was referred to the urology team. Further investigations were done – CT KUB with contrast showed bladder mass. Cystoscopy showed a Papillary tumour arising from bladder wall (Fig A)

Fig (A): Papillary tumour

Management and Outcomes

Transurethral resection of bladder tumour (TURBT) was done and specimen sent for histopathology. Histopathology showed Non invasive papillary urothelial carcinoma with predominantly low-grade morphology. A minor component (< 5%) exhibits high grade morphology. (Fig B) Deep muscle fibres were negative for malignancy. (Fig C)

Fig (B) & (C)

Fig (D): Papillary Urothelial Carcinoma

Stage: Ta (non-invasive papillary carcinoma)

Outcome: Follow up at 3 months with cystoscopy showed no recurrence.

Discussion

This case demonstrates the importance of routine screenings. Microscopic haematuria or a routine ultrasound abdomen may be the only clue. Early stage detection allows curative resection with good prognosis. Delayed diagnosis usually leads to higher grade/stage tumours, requiring intensive therapy.

Significance

Highlights the value of routine urine tests and abdominal ultrasound in annual exams. It encourages clinicians to investigate even minor urinary findings. It supports the idea that screening can be life-saving, especially in high-risk groups.

Conclusion

This case emphasizes the significance of routine health check-ups in detecting silent but potentially fatal conditions. An ultrasound abdomen led to early diagnosis and successful treatment in this case demonstrating the life-saving potential of preventive healthcare.

References

  1. European Association of Urology (EAU) Guidelines on Non-Muscle Invasive Bladder Cancer.
  2. Smith ZL et al. Incidental Detection of Bladder Cancer: Clinical Relevance and Implications J Urol.
  3. WHO Cancer Report 2024.
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