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.