Squamous cell lesions of the urinary bladder are considerably rare in the pediatric population. Therefore, we aimed to report a case of squamous cell papilloma in the urinary bladder of a girl with mitrofanoff appendicovesicostomy.

This case report was described from a tertiary care university hospital. Radiological, cystoscopic and histopathological assessment was performed. The patient was then subjected to postoperative renal and bladder ultrasonography (RBUS) for follow-up.

A 15-year-old girl presented with recurrent attacks of hematuria for six months. She had history of myelomeningocele closure at birth which was complicated with neurogenic bladder for which mitrofanoff appendecovesicostomy was done to facilitate clean intermittent catheterization (CIC). Her hemoglobin level dropped to 4 g/dL and she received 2 units of blood transfusion. RBUS and magnetic resonance urography (MRU) showed diffuse thickened bladder wall, small-sized right kidney with G IV hydronephrosis and normal left kidney (Figure 1). Voiding cystourethrogram showed right G V vesicoureteral reflux and small bladder capacity with irregular outline. Renal scan confirmed the poor tracer uptake of the right kidney and a well-functioning left kidney. Cystoscopic assessment showed hyperemic areas at the anterior bladder wall just close to the outlet opening in the bladder and lateral bladder walls. A transurethral biopsy was taken followed by fulguration of these areas and the histopathological result then revealed squamous cell papilloma with no evidence of malignancy (Figure 2). The patient was followed up 3 months later with no hematuria and accepted ultrasonographic findings.

A girl, who was maintained on CIC via mitrofanoff appendecovesicostomy for neurogenic bladder post myelomeningocele closure, presented with recurrent attacks of hematuria. Radiological images showed diffuse thickened bladder wall with small capacity, small-sized right kidney with G IV hydronephrosis and G V vesicoureteral reflux, and normal left kidney. Cystoscopic assessment revealed hyperemic areas at the anterior bladder wall just close to the outlet opening in the bladder and lateral bladder walls. The transurethral specimen showed squamous cell papilloma with no evidence of malignancy. After 3 months, the patient showed complete resolution of hematuria.

Squamous cell papilloma is a benign histopathological entity that could occur in the urinary bladder of patients who had previous bladder surgery and frequent bladder catheterization.