| A 56-year-old woman presented to the Urology Department with a history of recurrent left renourethral crisis of lithiasis. | |
| The only antecedent was hypertension for which she was being treated. | |
| At the time of the visit the patient is totally asymptomatic. | |
| Physical examination is anodyne. | |
| Blood tests with blood count and biochemistry were normal. | |
| The UIV showed a filling defect based on the cystogram. | |
| Ultrasound showed good echostructure of the kidneys and corticomedullary differentiation, but a nodular image was observed in the bladder wall of 2 x 1.3 cm near the trigone. | |
| The urine cytology after spontaneous voiding was negative for malignant cells. | |
| Cystoscopy prior to surgery showed a rounded right premeatic tumor completely covered by a normal urothelial mucosa, which already raises suspicion of a non-epithelial neoplasia. | |
| 1. | |
| The differential diagnosis made after Echo and the UIV was transitional cell carcinoma of the bladder (first among our suspected cases because of its frequency), bladder tumor of any other removed tumor, epithelial or not completely ruled out mucosa clotting. | |
| After spinal anesthesia, a bimanual examination is performed, suggesting that the tumor affects the entire thickness of the bladder wall and a complete biopsy TUR of the lesion. | |
| The appearance was solid tumor. | |
| The result of the histological study of the lesion was an intramural bladder leiomyoma. | |
| Transitional bladder mucosa is observed in the histological preparation, underlying it a proliferation of muscle fibers. | |
| 1. | |
| Subsequent controls to which the patient has been subjected consist of urine cytology of spontaneous voiding and ultrasound every 6 months, all of them normal. | |
| Currently, after two years of follow-up, the patient is asymptomatic from the urological point of view and has no recurrence. | |