Perivascular epithelioid cell neoplasm of the bladder with peritoneal metastasis

Perivascular epithelioid cell tumors (PEComas) are a diverse group of mesenchymal neoplasms. While they have been described throughout the genitourinary system, PEComas are quite rare within the bladder. We present the case of a 37-year-old male who presented in clot retention and was found to have a bladder PEComa. Staging images seemingly demonstrated solid tumor confinement to the bladder and pelvis. Intraoperative pathology revealed peritoneal metastasis. The patient underwent a pelvic mass excision and partial cystectomy. The patient had plans for adjuvant chemotherapy, but later returned to the hospital and passed away from acute hypoxic respiratory failure.