Coexistence of Malakoplakia and Papillary Urothelial Carcinoma of the Urinary Bladder

Malakoplakia is a rare granulomatous disease that commonly involves the genitourinary tract, with the urinary bladder being the most frequently affected site. Grossly, malakoplakia can present as soft yellow plaques, nodules, bladder mass, or even without any visible lesion. In this article, we present a 74-year-old female with a background of hypertension, hyperlipidemia, and poorly controlled diabetes who presented with sepsis of unknown origin. During the course of the investigation of the source of her sepsis, an incidental bladder tumor was discovered. She subsequently underwent transurethral resection of the bladder tumor. Histology revealed ordinary low-grade papillary urothelial carcinoma that had small colonies of malakoplakia that appeared to have developed secondary to the tumor and presented concurrently. We seek to demonstrate the rare association of papillary urothelial carcinoma and malakoplakia.