A rare case of asymptomatic leiomyoma of the urinary bladder

@#Leiomyoma of the urinary bladder is not often encountered, occurring in only 0.43% of all bladder tumors. Among the known cases, patients usually present with obstructive symptoms, irritative symptoms or hematuria. This is a rare case of a 50-year-old male who was incidentally diagnosed to have a bladder mass. After cystoscopy, an open partial cystectomy was done with complete resection of the bladder mass. Final histopathology and immunochemical stains confirmed the diagnosis of leiomyoma of the urinary bladder.

Use of computed tomography scout film and Hounsfield unit of computed tomography scan in predicting the radio-opacity of urinary calculi in plain kidney, ureter and bladder radiographs

The objective of this study is to determine the diagnostic utility of computed tomography [CT]- scout film with an optimal non-contrast helical CT scan Hounsfield unit [HU] in predicting the appearance of urinary calculus in the plain kidneys, ureter, urinary bladder [KUB]-radiograph. A prospective cross-sectional study was executed and data were collected from June 2007 to June 2012 at a tertiary hospital. The included subjects were diagnosed to have <10mm urolithiasis with noncontrast helical CT scan and KUB X-ray, which were carried out on the same day. Both KUB radiographs and CT-scout film were read by two qualified radiologists with inter-observer standardization prior to the study. Urolithiasis characteristics such as stone location, CT attenuation value, CT-scout film and KUB radiograph appearance were recorded independently by two observers. Univariate logistic analysis with receiver operating characteristic curve was generated to determine the best cut-off HU value of urolithiases not identified in CT-scout film, but determined radio-opaque in KUB X-ray. Subsequently, its sensitivity, specificity, predictive values and likelihood ratios were calculated. Statistical significance was set at P value of 0.05 or less. Two hundred and three valid cases were included. 73 out of 75 CT-scout film detected urolithiasis were identified on plain radiograph and determined as radio-opaque. The determined best cut off value of HU utilized for prediction of radiographic characteristics was 630HU at which urinary calculi were not seen at CT-scout film and were KUB X-ray radio-opaque. The set HU cut-off was established of ideal accuracy with an overall sensitivity of 82.2%, specificity of [6.[% and a positive predictive value of [6.5% and negative predictive value of 83.5%. Urolithiases identified on the CT-scout film were also seen as radiopaque on the KUB radiograph while those stones not visible on the CT-scout film, but above the optimal HU cut-off value of 630 are also likely to be radiopaque