Introduction: Bladder endocervicosis (BE) is a rare benign condition characterized by the presence of endocervical-type glands within the bladder wall. Prior Cesarean section or pelvic surgery appears to be a significant risk factor predisposing to BE. Chronic pelvic pain in women is a common symptom of BE. Bladder endocervicosis’s inherent capability to mimic malignancy radiologically and endoscopically may pose a clinical conundrum. Case Report: A 38-year-old female presented with a five-year history of sharp, stabbing pelvic pain during urination. Magnetic resonance imaging (MRI) revealed a thickened bladder wall and abdominal scar tissue forming a connection between the lower uterine segment and the posterior dome of the urinary bladder. However, no identifiable mass was reported on MRI. Flexible cystoscopy revealed a solid, mass-like lesion with papillary projections on the posterior bladder wall. Histopathological examination of the urinary bladder mass-like lesion revealed benign urothelium with numerous scattered, irregular, and dilated glands lined by columnar mucin-producing epithelium that resembled endocervical glands. Immunohistochemical staining was positive for estrogen receptor (ER) and mucin. Following a 6-week post-operative period, the patient has demonstrated abrupt complete recovery of symptoms. Conclusion: An effective multidisciplinary approach, including macroscopic evaluation via cystoscopy and histopathological microscopic evaluation, excludes potential malignancy mimickers. Surgical resection leads to complete resolution of symptoms.
Alowami et al. (Wed,) studied this question.