A rare case of plasmacytoid urothelial carcinoma of bladder: Diagnostic dilemmas and clinical implications

Plasmacytoid urothelial carcinoma is an uncommon and aggressive variant of urothelial carcinoma associated with late presentation and poor prognosis. We discuss here the first reported case from India of a 54-year-old male who presented with hematuria. Cystoscopy showed edematous and ulcerated mucosa throughout the bladder. A transurethral biopsy revealed urothelial carcinoma with plasmacytoid appearance. He underwent a radial cystectomy which on histopathology showed plasmacytoid urothelial carcinoma of the bladder of high stage with involvement up to bladder serosa and adventitial walls of the ureter. The diagnostic dilemmas of this unusual variant of urothelial malignancy and its clinical impact are discussed.