Differential Diagnosis for Exophytic Indentation Bladder in a 70-Year-Old Female with Haematuria
- Single Most Likely Diagnosis
- Bladder Cancer (Transitional Cell Carcinoma): This is the most likely diagnosis given the patient's age, symptoms of haematuria, and the presence of an exophytic indentation in the bladder. Bladder cancer is common in older adults and often presents with painless haematuria.
- Other Likely Diagnoses
- Bladder Stones: Although less common than bladder cancer in this demographic, bladder stones can cause haematuria and could potentially cause an indentation if they are large enough.
- Inflammatory Bladder Conditions (e.g., Interstitial Cystitis): These conditions can cause bladder wall changes and haematuria, though they are less likely to cause a distinct exophytic indentation.
- Do Not Miss Diagnoses
- Metastatic Disease to the Bladder: Although rare, metastases from other primary cancers (e.g., breast, colon, or melanoma) can involve the bladder and cause similar symptoms. Missing this diagnosis could have significant implications for treatment and prognosis.
- Invasive Fungal Infections: In immunocompromised patients, fungal infections can cause bladder wall lesions and haematuria. This diagnosis is critical to consider due to its potential for severe morbidity and mortality if not promptly treated.
- Rare Diagnoses
- Bladder Endometriosis: This condition can cause bladder wall nodules and cyclical haematuria in females, especially if the endometriosis involves the bladder.
- Malacoplakia: A rare inflammatory condition that can affect the bladder and cause nodular or plaquelike lesions, potentially leading to haematuria.
- Bladder Sarcoma: Sarcomas are rare tumors that can occur in the bladder and present with similar symptoms to bladder cancer, including haematuria and a mass.