Delayed diagnosis of bladder squamous cell carcinoma secondary to massive bladder stone

A 53-year-old man presented to a local hospital for 4 months with lower back discomfort. Abdominal computed tomography (CT) revealed a 76 × 74 mm bladder stone. He then underwent bladder incision for stone removal and diversion. Post-surgery, the incision became infected and did not heal. Abdominal CT and pelvic magnetic resonance imaging showed thickened bladder walls and soft tissue in the front of the pelvic area. Pathological examination of abdominal wall tissue biopsy indicated moderately differentiated squamous cell carcinoma. He later received chemotherapy along with immunotherapy. Follow-up CT showed no tumor shrinkage and persistent bleeding. Although rare, bladder squamous cell carcinoma secondary to bladder stones requires awareness to avoid delayed diagnosis and improve early treatment.