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Urinary Imaging

E1012. Not the Usual Suspects: A Pictorial Review of Unusual Bladder and Prostate Masses

Lee Y,  Gulati M,  Duddalwar V,  Romero M. LAC+USC Medical Center, Los Angeles, USA

Address correspondence to Y. Lee (YLee2@dhs.lacounty.gov)

Background Information: Bladder and prostate tumors are encountered in routine clinical practice, the vast majority of which are epithelial in origin. However, a wide spectrum of pathologic entities, both benign and malignant exist, including many rarer tumors. The purpose of this exhibit is to familiarize the participant with unusual bladder and prostate lesions.

Educational Goals/Teaching Points: We present examples of unusual bladder and prostate lesions on multiple imaging modalities including ultrasound, CT, MRI, and PET; review a variety of nonneoplastic disorders that may mimic malignancies; and discuss salient imaging and clinical features to help formulate an appropriate differential diagnosis.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: This exhibit encompasses benign bladder entities (inflammatory pseudotumors and blood clots), malignant bladder entities (squamous cell carcinoma, leiomyosarcoma, carcinosarcoma, small cell tumor, metastatic disease, carcinoma of the bladder diverticula, and urachal adenocarcinoma), benign prostate entities (abscess, multilocular cystadenoma, and cryoablation changes), and malignant prostate entities (leiomyosarcoma, carcinosarcoma, and neuroendocrine tumor).

Conclusion: The majority of bladder and prostate masses represent urothelial cell and adenocarcinomas, respectively. However, given the broad scope of pathologies that constitutes the remaining minority of cases, it is important for radiologists to be aware of rarer entities to help guide appropriate follow-up and management.