Bilharzial-associated Squamous Cell Carcinoma of the Bladder in Pregnancy: A Case Report

  • Suwilanji Simwanza, Mr Young Emerging Scientists Zambia, Lusaka, Zambia. The University of Zambia, School of Medicine P.O Box 50110, Nationalist Road, Lusaka, Zambia.
  • Mwansa Ketty Lubeya Department of Obstetrics and Gynaecology, The University of Zambia School of Medicine
  • Patricia Chipalabwe, Dr. Women and Newborn Hospital, University Teaching Hospitals P/B RW1X, Nationalist road, Lusaka, Zambia.
  • Jane Chanda Kabwe, Dr Department of Anaesthesia and critical care, MIE University. Young Emerging Scientists, Lusaka, Zambia
  • Aaron Nyirenda, Dr Department of Pathology, University Teaching Hospitals, Nationalist road, Lusaka, Zambia
  • Dorothy Lombe Cancer Diseases Hospital, Lusaka, Zambia
  • Lackson Kasonka, Dr 1Department of Obstetrics and Gynaecology, The University of Zambia School of Medicine P.O Box 50110, Nationalist road, Lusaka, Zambia. Women and Newborn Hospital, University Teaching Hospitals P/B RW1X, Nationalist road, Lusaka, Zambia.
Keywords: Schistosoma haematobium, pregnancy, squamous cell carcinoma, bladder cancer, bilharzia, zambia, sub-sahara Africa

Abstract

Squamous cell carcinoma (SCC) of the bladder is a rare and devastating malignancy, usually associated with Schistosoma haematobium, particularly in bilharzia-endemic regions of sub-Saharan Africa. Little is written about the condition in pregnancy.

A 21-year-old Gravida 2 Para 1 at 28 weeks gestation presented with worsening symptoms of dysuria, increased frequency of micturition, backache, a painful suprapubic mass and haematuria over a period of 3 weeks. On examination, vital signs were normal, the height of fundus was 26cm, with a tender suprapubic mass. Extraperitoneal laparotomy revealed multiple signs of a bladder malignancy which were confirmed by histopathology as Schistosoma haematobium ova and invasive keratinising SCC of the bladder, grade 1. Intraoperatively, T4 carcinoma staging was confirmed. The patient was delivered prematurely by caesarean section due to worsening symptoms. Palliative care was instituted as the functional status of the patient did not allow for definitive management.

Subclinical urinary schistosomiasis can progress to a SCC of the bladder, presenting with symptoms implicated in conditions such as bladder lithiasis, Urinary tract infections and pregnancy. Urine cytology and mass drug administration should be enforced as means of early detection and prevention, respectively in endemic regions.

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Published
2022-01-11
How to Cite
Simwanza, S., Lubeya, M., Chipalabwe, P., Kabwe, J., Nyirenda, A., Lombe, D., & Kasonka, L. (2022). Bilharzial-associated Squamous Cell Carcinoma of the Bladder in Pregnancy: A Case Report. Medical Journal of Zambia, 48(3), 346 - 349. Retrieved from https://mjz.co.zm/index.php/mjz/article/view/904
Section
Case Reports