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Bladder cancer most commonly exists as an epithelial tumor in which around 90% of cases are transitional cell carcinoma (TCC) with a papillary appearance. The world health organization (WHO) classification defines new histological and molecular variants of urothelial carcinoma in 2004. One of them is plasmacytoid urothelial carcinoma (PUC). Less than 100 cases have been reported in the literature (with a reported incidence of up to 3%).There is limited data available on the clinicohistological features or prognosis of PUC. We reported a 58-year-old man with a complaint of right flank pain that referred to testis accompanied by gross hematuria and history of heavy smoking. Imaging showed polypoid mucosal thickening in posterolateral wall of bladder base. Patient was treated with TURBT and BCG. Finally, pathological study confirmed clinicodiagnosis of TCC (plasmacytoid type). PUC is a poor prognostic variant of TCC and early diagnosis is important. Review of other literatures showed early diagnosis of plasmacytoid urothelial carcinoma (PUC) cannot be made due to the absence of hematuria until the late stage of the disease. Cystoscopy and biopsy for earlier diagnosis of PUC because of delayed occurrence of hematuria are required. Patient follow-up after treatment for this variant of urothelial carcinoma is highly recommended. Further studies are needed for evaluation of relationship between smoking and PUC.

Keywords: Plasmacytoid urothelial carcinoma, bladder, cystoscopy

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