A Bladder Stone Masquerading as Recurrent Tumor: A Diagnostic Pitfall in Post-TURBT Surveillance

Abstract Background: Lesions arising at sites of prior transurethral resection of bladder tumor (TURBT) are often presumed to indicate tumor recurrence, especially in patients with a known history of urothelial carcinoma. However, non-neoplastic mimics exist, which may lead to overtreatment if not properly identified. Case Presentation: We report the case of an 80-year-old man with a prior diagnosis of low-grade bladder cancer who was found to have a polypoid lesion at the TURBT scar site during routine surveillance. Although malignancy was suspected, biopsy and histological evaluation revealed a crystalline-rich necrotic mass consistent with a cystolith. Conclusion: This rare presentation highlights how bladder stones, particularly when adherent to the urothelial mucosa, can simulate neoplastic polyps. Vigilance and confirmatory pathology are essential in such cases to avoid misdiagnoses.