A Rare Case of Primary Squamous Cell Carcinoma of the Urinary Bladder Associated With a Large Bladder Diverticulum

Carcinoma of the urinary bladder is one of the most frequently encountered malignancies of the genitourinary tract, with urothelial carcinoma constituting the predominant histological subtype.Primary squamous cell carcinoma (SCC) of the urinary bladder is an uncommon entity, accounting for only a small proportion (1-3%) of bladder cancers.It is usually associated with chronic irritation and inflammation of the bladder mucosa and is often diagnosed at an advanced stage, leading to an unfavorable prognosis.We report a rare case of primary SCC of the urinary bladder in a 69-year-old male patient who presented with longstanding irritative lower urinary tract symptoms, recurrent urinary tract infections, and intermittent hematuria.Radiological evaluation revealed an irregular bladder mass associated with a large bladder diverticulum.Cystoscopy, biopsy, and immunohistochemistry confirmed the diagnosis of moderately differentiated keratinizing SCC, stage pT1N0M0.The patient was managed with neoadjuvant chemotherapy and immunotherapy, followed by radical cystectomy, with histopathology showing SCC of the urinary bladder and negative lymph nodes (ypT1N0M0).This case highlights the importance of early suspicion, histopathological confirmation, and a multidisciplinary treatment approach in managing this rare and aggressive bladder malignancy.