Bladder masses simulating neoplasia in chronic granulomatous disease: Diagnostic challenges and spontaneous regression

Chronic granulomatous disease (CGD) rarely involves the lower urinary tract, and bladder mass-like lesions are exceptionally uncommon. We report a 23-year-old male with CGD who presented with gross hematuria and multiple large papillary bladder masses on imaging and cystoscopy. Cold-cup biopsies suggested papillary urothelial proliferation but were inconclusive due to limited sampling. Remarkably, repeat cystoscopy and MRI one month later showed complete resolution of all lesions. This case highlights the potential for CGD-related reactive or inflammatory changes to mimic neoplasia and emphasizes the importance of cautious interpretation and short-interval reassessment in such patients.