Chronic Irritation to Malignancy: A Case of Squamous Cell Carcinoma of The Suprapubic Catheter Tract Extending into Bladder in A 46-Year-Old Man.

Abstract

Background: Squamous cell carcinoma (SCC) of the suprapubic cystostomy (SPC) tract is a rare but serious complication of long-term catheterization. Chronic irritation, recurrent infections, and metaplastic changes contribute to its pathogenesis. While SCC of the bladder is well-documented, neoplastic transformation at the SPC site remains uncommon, with limited cases reported in the literature.

Case Presentation: A 46-year-old man with a history of traumatic urethral stricture and long-term suprapubic catheterization presented with a non-healing ulcer, hematuria, and foul-smelling discharge at the catheter site. Examination revealed an ulcerated mass, and imaging confirmed local tumor invasion with left-sided hydronephrosis but no distant metastasis. Histopathology confirmed well-differentiated SCC. The patient underwent primary radiotherapy (65 Gy in 35 fractions), leading to near-complete tumor resolution.

Conclusion:  This case highlights the need for vigilance in patients with chronic SPC use who present with persistent ulcerative lesions. Primary radiotherapy may be a viable treatment option. Close surveillance remains crucial to monitor for recurrence.

Keywords:

Suprapubic cystostomy, Squamous cell catheter, Metaplasia, Chronic irritation

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