Need for early imaging in symptomatic suprapubic catheter tracts: Rare case of cutaneous squamous cell carcinoma of tract origin without bladder involvement

摘要

We report a case of a 91-year-old female with an indwelling suprapubic catheter (SPC) for the last 11 years for a contracted bladder post-radiotherapy for previous uterine carcinoma. She presented with persistent lower abdominal pain and superficial induration surrounding her suprapubic cystostomy tract. Radiological and histopathological examination revealed cutaneous squamous cell carcinoma arising from the tract involving the rectus muscle but without bladder involvement. This is only the third case reported in the literature of such malignancy developing in a suprapubic cystostomy tract without metastases and intravesical disease. Urologists and physicians should remain vigilant of such subtle presentations in those with longstanding SPCs to facilitate early investigation and diagnosis. We conclude that solely performing flexible cystoscopy on symptomatic patients with SPCs is often not enough. This case highlights the importance of clinical examination of the abdomen and superficial SPC tract with appropriate early computed tomography (CT) imaging and biopsies to avoid missing malignant pathology.