MALAKOPLAKIA OF THE BLADDER MIMICKING MALIGNANCY: REPORT OF CASES AND REVIEW OF THE LITERATURE

Abstract

Malakoplakia is a rare granulomatous disease associated with an infectious etiology, usually involving the urinary tract. Clinical presentation malakoplakia is often non-specific, but is typically characterized by recurrent urinary tract infections and hematuria. The etiology of malakoplakia has not been fully elucidated. Frequent association of bladder malakoplakia with urinary tract infection suggests an infectious etiologic agent Malakoplakia of the genitourinary system is more common in women than in men. It is usually observed between the fifth and seventh decades of life. We report a rare case of isolated bladder malakoplakia in a 25-year-old female patient who presented with lower urinary tract symptoms without any hematuria. Clinically, a 15,0 х 11,0 15,0 mm mass was detected in the bladder, which was confirmed by ultrasound scan and magnetic resonance imaging. Malakoplakia is complicated diagnostic problem, since it occurs very rare and can manifest in a different way. Only histological research allows to determine the correct diagnose. The final diagnosis is confirmed by the presence of Michaelis-Gutmann bodies. The majority of patients after being precisely diagnosed can be successfully cured by the lasting treatment of antibiotics in a smaller dose. Represented clinical observation illustrates highly rare case of malakoplakia of bladder. It demonstrates the possibility of usage low invasive surgery not only for diagnostic, but also for therapy. This case made possible to receive the macro preparate for histological research of excellent quality. Histology is essential, not only to diagnose malakoplakia, but also to exclude other important differential diagnoses, such as malignancy. Histopathological examination of the tumor-like mass revealed malakoplakia. Postoperative course was uneventful. This condition should be included in the differential diagnosis of bladder tumors.