Am. J. Trop. Med. Hyg., 78(4), 2008, pp. 538
Copyright © 2008 by The American Society of Tropical Medicine and Hygiene
Schistosomiasis in a 43-Year-old African Immigrant from Mali with Invasive Squamous Cell Carcinoma of the Urinary Bladder
Tobe Momah*,
Dejan Etwaru, AND
Enedina Sungcad
A 43-year-old African immigrant from Mali was seen and treated at our facility for a recently exacerbated episode of hematuria that had been intermittent and non-remitting for the past 36 years. On cystoscopy the left lateral and anterior wall mucosa were replaced by tumor; a 6 x 6 x 2 cm friable and fungating lesion was visible at the bladder neck. Pathological results showed invasive squamous cell carcinoma of the urinary bladder moderately differentiated involving the base, dome, anterior, posterior, and lateral wall of the urinary bladder. The patient then underwent a radical cystoprostatectomy, pelvic lymph node dissection, and ileal neo-bladder placement following a surgical staging of the disease as involving the prostate. Pathological examination revealed a stage 4 lesion with the involvement of the prostate and distant lymph nodes and pathologic staging as pT3a, pN2, pMX AJCC. The patient died 7 months after presentation following complications of septicemia.
View larger version (106K):
[in this window]
[in a new window]
|
FIGURE 2. Gross picture of radical cysto-prostatectomy specimen for invasive squamous cell carcinoma that shows a fungating friable tumor involving the anterior, posterior, and lateral walls of urinary bladder from base to dome. This figure appears in color at www.ajt-mh.org.
|
|
View larger version (139K):
[in this window]
[in a new window]
|
FIGURE 3. Invasive squamous cell carcinoma showing keratinization and pearl formation (hematoxylin-eosin, original magnification x 400). This figure appears in color at www.ajtmh.org
|
|
View larger version (136K):
[in this window]
[in a new window]
|
FIGURE 4. Schistosoma haematobium egg with terminal spine in area of invasive squamous cell carcinoma of the urinary bladder. Inset shows this prominent terminal spine on egg of parasite (hematoxylin-eosin, original magnification x400 and x600 [inset]). This figure appears in color at www.ajtmh.org.
|
|
Received December 28, 2007.
Accepted for publication January 31, 2008.
* Address correspondence to Tobe Momah, 121 Dekalb Avenue, Brooklyn, NY 11201. E-mail: tobemomah{at}yahoo.com 
Authors’ addresses: Tobe Momah, Dejan Etwaru, and Enedina Sungcad, 121 Dekalb Avenue, Brooklyn, NY 11201. Tel: 718-250-8817, Fax: 718-250-6009, E-mail: tobemomah{at}yahoo.com.
