A 45-year-old woman presented to the urology department with voiding syndrome and recurrent urinary tract infections.
The patient had a history of hypothyroidism, hypertension in usual treatment with atenolol and enalapril, a 10-cigarette smoker day and cholecystectomy.
Physical examination showed no pathological findings.
Renal and bladder ultrasound showed irregular thickening of the bladder wall.
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Cystoscopy was subsequently performed, revealing a low capacity bladder with neoformation of approximately 5 cm in diameter of solid aspect in the left lateral face towards the bottom and anterior face, with an inflammatory aspect and poorly defined limits.
Non-pelvic CT scan showed a bladder with diffuse thickening of its wall, being more important on the left side.
After contrast administration, diffuse uptake of the entire bladder wall with marked enhancement of the left parietal mucosa is observed.
No retroperitoneal or mesenteric adenomegaly was observed.
Urine cytology was negative on two occasions for tumor cells.
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These findings were obtained by transurethral resection of bladder neoformation and random bladder biopsies.
The samples obtained were sent for pathological analysis, in which there is evidence of diffuse proliferation of spindle cells and elongated at the level of the dry lamina propria, with large vascular neoformation; also, there are nodular structures arranged in Wag
Median immunohistochemistry is confirmed that spindle cells and Wagner-Meissner bodies are strongly positive against diffuse antiserum S-100, so the diagnosis of bladder wall fibroma is confirmed.
The patient was referred to Internal Medicine consultation to continue the study and rule out other manifestations of neurofibromatosis in other organs.
Likewise, the patient is periodically followed up by urology consultation to monitor the appearance of new formations.
