Squamous Cell Carcinoma of the Bladder in a 25-Year-Old Male Complicating a Case of Vesical and Extra-vesical Schistosomiasis: A Case Report and Literature Review

Abstract

Background: Schistosomiasis, a neglected tropical disease caused by parasitic flatworms, rarely presents with squamous cell carcinoma (SCC) of the bladder. We report a unique case of SCC of the bladder in a young male with concomitant schistosomiasis and extensive extra-vesical involvement. Case Presentation: A 25-year-old male presented with gross hematuria and lower abdominal pain. Diagnostic workup including complete blood count, renal function test, bilateral upper extremities, creatinine, Abdominopelvic Ultrasound, Computer Tomography scan was done. A diagnostic Cystoscopy with biopsy revealed a huge Bladder mass and confirmed as SCC of the Bladder on biopsy. Intraoperatively, a huge bladder mass was found, the Appendix and omentum were adhered to the Urinary bladder. A palliative radical cystectomy with Urinary diversion using ileum conduit was carried out. Appendectomy and partial Omentectomy were also carried out. Histopathological examination of resected tissues confirmed schistosomiasis-induced pathology, SCC of the Bladder with schistosoma eggs infiltrating the appendix and omentum, indicating disseminated disease. Conclusion: This case underscores the rare co-occurrence of SCC of the bladder and disseminated schistosomiasis in a young adult. Timely identification of schistosomiasis and suitable antiparasitic treatment, together with consistent monitoring for possible sequelae, is essential in mitigating the risk of SCC. Heightened awareness among healthcare workers, particularly in endemic regions, is essential for the early identification and timely management of schistosomiasis. Moreover, public health initiatives focused on managing schistosomiasis via enhanced sanitation, health education, and mass medicine distribution are essential for reducing the incidence of schistosomiasis-related cancers. The results of this case indicate a necessity for additional investigation into the pathophysiological pathways connecting schistosomiasis to bladder cancer, especially in younger demographics, and for the formulation of targeted screening methods for at-risk persons.