Case history and examination
A 64-year-old male patient with a history of Bladder Cancer diagnosed in
Zimbabwe sought further medical care and treatment in South Africa.
Initially, the patient presented with painless hematuria accompanied by
clots. The patient is a non-smoker with no relevant occupational
exposures. He had previously been treated for bilharzia during childhood
and has a known history of diabetes and hypertension, managed with
insulin and two antihypertensive medications. Past surgical history
includes TURBT procedures in Zimbabwe on 07/11/2022, revealing low-grade
papillary urothelial carcinoma with crush artifact limiting diagnostic
evaluation, detrusor not identified in specimen, a second TURBT on
07/02/2023 showing chronic cystitis with no dysplasia or malignancy and
presence of Schistosomiasis, and a third TURBT on 10/08/2023 displaying
invasive moderately differentiated urothelial cancer with detrusor not
identified and presence of schistosomiasis in specimen.
Clinically, the patient appeared not acutely or chronically unwell with
no abnormalities noted on general examination. Abdominal examination did
not reveal any palpable masses. Additionally, there were no
abnormalities detected on respiratory, cardiovascular, or central
nervous system examination. Digital rectal examination showed a benign
prostate and a palpable mobile bladder mass on bimanual examination.