Inflammatory pseudotumor of the urinary bladder presenting as a symptom of active vasculitis in a patient with granulomatosis with polyangiitis (Wegener's) - an unusual manifestation of ANCA-associated vasculitis

Abstract

ranulomatosis with polyangiitis (GPA) is the most common type of ANCA-associated vasculitides (AAV) occurring in the Czech Republic. AAV are (predominantly) small-vessel vasculitides that can afflict any organ in the human body.

Urogenital involvement is relatively rare and can cause diagnostic challenge. This is a case report of a female patient with GPA presenting with urinary bladder pseudotumour.

Urinary bladder carcinoma was initially suspected. Its differentiation from localized inflammatory process caused by active vasculitis was very important as the treatment of GPA includes potentially toxic cyclophosphamide.

Establishment of the right diagnosis was enabled by assessment of the biopsy by experienced pathologist. As documented by serial repeated CT scans, immunosuppressive therapy led to complete regression of the finding in the urinary bladder.

Conclusion: GPA symptoms vary widely and may mimic cancer. Right and timely diagnosis of GPA may save the patient from an unnecessary surgical procedure or even chemotherapy.