Short communication: Urinary schistosomiasis mimicking a bladder tumour in a Somali student diagnosed in Türkiye

Abstract

Urinary schistosomiasis caused by Schistosoma haematobium may mimic bladder malignancy in patients evaluated outside endemic regions. We report a 20-year-old Somali university student who had been living in Türkiye for two years and had a history of freshwater exposure in Somalia. He presented with painless macroscopic haematuria and lower urinary tract symptoms. An initial 50-mL urine sample collected at 11:00 showed no parasitic structures; a repeat 20-mL terminal-stream sample collected at 13:30 on the same day revealed characteristic terminal-spined S. haematobium eggs on unstained light microscopy of centrifuged urine sediment. Cystoscopy demonstrated an approximately 2-cm sessile bladder lesion suspicious for malignancy and diffuse yellowish granular mucosal lesions (‘sandy patches’). Transurethral resection revealed eosinophil-rich chronic active cystitis and subepithelial schistosome eggs without dysplasia or malignancy. The patient received praziquantel. This case illustrates the importance of epidemiological history, repeated urine microscopy, and recognition of characteristic cystoscopic findings when evaluating bladder masses in patients from endemic regions.