Squamous cell carcinoma caused by neglected giant bladder diverticulum stone

The incidence of bladder diverticulum is approximately 1.7% in children and 6% in adults. Dysplasia, leukoplakia, and squamous metaplasia may develop in approximately 80% of diverticulum. Chronic infection and inflammation, secondary to urinary stasis have been suggested as the cause of this situation. Bladder tumors arising inside of a diverticulum are uncommon, with a reported incidence ranging from 0.8% to 10% so discussions related to the diagnosis and the treatment of these cases are pending. The most common histological subtype of diverticulum tumors are transitional cell carcinoma (TCC) and squamous cell carcinoma (SCC), constitute 70-80% and 20-25% of all tumors respectively. TCC together with SCC is reported as 2% of all tumors, adenocarcinoma constitutes only a 2% portion. Stasis in the diverticulum may give rise to stone formation. Literature holds a large number of cases dealing with squamous cell carcinoma caused by bladder diverticulum. Until now, a case report depicting the coexistence of these pathologies (SCC, diverticulum and diverticulum stone) simultaneously in one case has not been reported. In our case, neglected bladder diverticulum stones may have caused SCC. Our case was treated with radical cystectomy. Urologists should be vigilant in this regard and diverticulum should be managed before complications happen.