Endocervicosis of the urinary bladder: A case report

Introduction: Bladder endocervicosis (BE) is a rare benign condition characterized by the presence of endocervical-type glands within the bladder wall. Prior Cesarean section or pelvic surgery appears to be a significant risk factor predisposing to BE. Chronic pelvic pain in women is a common symptom of BE. Bladder endocervicosis’s inherent capability to mimic malignancy radiologically and endoscopically may pose a clinical conundrum. Case Report: A 38-year-old female presented with a five-year history of sharp, stabbing pelvic pain during urination. Magnetic resonance imaging (MRI) revealed a thickened bladder wall and abdominal scar tissue forming a connection between the lower uterine segment and the posterior dome of the urinary bladder. However, no identifiable mass was reported on MRI. Flexible cystoscopy revealed a solid, mass-like lesion with papillary projections on the posterior bladder wall. Histopathological examination of the urinary bladder mass-like lesion revealed benign urothelium with numerous scattered, irregular, and dilated glands lined by columnar mucin-producing epithelium that resembled endocervical glands. Immunohistochemical staining was positive for estrogen receptor (ER) and mucin. Following a 6-week post-operative period, the patient has demonstrated abrupt complete recovery of symptoms. Conclusion: An effective multidisciplinary approach, including macroscopic evaluation via cystoscopy and histopathological microscopic evaluation, excludes potential malignancy mimickers. Surgical resection leads to complete resolution of symptoms.