title: Squamous cell carcinoma of the bladder in a female associated with multiple bladder stones.
abstract: BACKGROUND
  Bladder cancer is the most common malignancy in the urinary tract. Urothelial carcinoma is the most common histologic type of bladder cancer in the United States, accounting for approximately 90%. Squamous cell carcinoma is less common, making up 3-5% of bladder cancers. We present a case of squamous cell carcinoma in a female associated with multiple bladder stones.
  
  
  METHODS
  A 76-year-old Caucasian woman presented to the emergency department with gross hematuria and dysuria for one month. Urinalysis showed many RBCs and WBCs with positive nitrite. She was admitted with an initial impression of urinary tract infection and intravenous ceftriaxone was started. Urine culture grew greater than 100,000 cfu/ml of Enterococcus species. Computed tomographic imaging of the abdomen/pelvis with oral contrast revealed a markedly distended bladder with hemorrhage, multiple calculi, and diffuse bladder wall thickening. Cystoscopy was performed for diffuse bladder wall thickening and demonstrated numerous bladder stones, a bladder mass, and organized blood clots. Biopsy of the mass was consistent with high-grade carcinoma with squamous differentiation. The bladder cancer was not surgically resectable and radical cystectomy was not recommended due to old age and poor functional status. The patient refused chemotherapy and she died in 6 months.
  
  
  CONCLUSIONS
  The association between foreign bodies in the bladder and sqaumous cell carcinoma is well established. Long-standing bladder stones have been implicated as a cause of squamous cell carcinoma of the bladder. Our female patient's unusual presentation with multiple bladder stones and sqaumous cell carcinoma of the bladder highlights the association between these two conditions.
authors.affiliation: College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA. jaehcho@illinois.edu.
authors.forename: Jae Hyung
authors.initials: JH
authors.lastname: Cho
authors.forename: Jean L
authors.initials: JL
authors.lastname: Holley
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D001743:Urinary Bladder / Q000473:pathology; D001744:Urinary Bladder Calculi / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D001749:Urinary Bladder Neoplasms / Q000150:complications / Q000175:diagnosis / Q000473:pathology*