Endometriosis Simulating Bladder Cancer - Revista Brasileira de Ginecologia e Obstetrícia

Purpose: urinary tract involvement by endometriosis is uncommon and the bladder is the most common site. We observed that clinical misdiagnosis of bladder cancer frequently is made. Because the disease is generally described in case reports there is not a consensual management. We present and discuss our experience of diagnostic and therapeutic issues. Methods: retrospective analysis of urinary endometriosis slides of the Department of Pathology files was made. Medical charts and follow-up were reviewed in detail and interviews were performed during or after treatment. Results: we describe four cases with cyclic disuria, abdominal mass, pelvic pain and imaging diagnosis of bladder tumor. Pathological specimens were obtained by endoscopic resection (3 cases) and laparoscopic biopsy (1 case). Therapeutic options were exclusive medical treatment or surgical removal with transurethral resection or partial cystectomy supplemented with adjuvant medication. Conclusions: we review the clinical and therapeutic aspects of urinary tract endometriosis stressing that this is an important differential diagnosis of bladder cancer in reproductive women.