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Abstract
Urothelial carcinoma is overwhelmingly the most common bladder tumor, but it is important to be aware of the other epithelial and mesenchymal tumors that can occur. There is a significant overlap in the clinical history and imaging findings of the various bladder tumors, and ultimately they all require biopsy for diagnosis. However, some tumors such as botryoid rhabdomyosarcoma, plexiform neurofibroma, solitary fibrous tumor, leiomyomas, and urachal adenocarcinoma have highly suggestive features, which should alert the radiologist to the diagnosis. Cross-sectional imaging plays an important role for tumor staging and directing appropriate management, with CT and MR imaging having comparable accuracies.
The discovery of a focal bladder mass usually requires pathologic evaluation. Although bladder neoplasms are common, there are a number of nonneoplastic and inflammatory disorders that can manifest as a focal bladder mass and mimic malignancy. Some of these entities, such as inflammatory pseudotumor, endometriosis, Crohn disease, diverticulitis, ureterocele, and benign prostatic hyperplasia, have radiologic features highly suggestive of the diagnosis and should be recognized by the radiologist to prevent unnecessary radical surgery. Diffuse bladder wall thickening has a longer list of differential diagnoses, and clinical and pathologic correlation is required.