DESCRIPTION

A 68-year-old lady normally fit and well who was referred with a history of a single episode of visible haematuria and intermittent lower urinary tract symptoms (LUTS) characterised by frequency, urgency and feeling of incomplete bladder empty-ing. She was investigated with a renal ultrasound which showed a vascular 37 mm×37 mm mixed echo-rounded mass lying centrally. She then had a flexible cystoscopy which demonstrated a solid-looking bladder tumour. Based on these she had a CT scan and a transurethral resection of the bladder mass. CT scan showed a well-circumscribed bladder mass with central areas of low attenuation originating from the bladder neck (figures 1–3). The histology of the resection came back as showing a leiomyoma. Her LUTS resolved after the surgery. She had a check flexible cystoscopy 9 months after her surgery which showed no recurrence. The CT images show a large well-circumscribed bladder lesion with no extravesical abnormality which is in keeping with a leiomyoma of the bladder.1 2 Learning points ▸ Lower urinary symptoms can be presenting complaints of benign bladder tumours. ▸ Diagnosis of leiomyoma can be made with imaging techniques. Competing interests None. Patient consent Obtained. Provenance and peer review Not commissioned; externally peer reviewed