Giant 2,150-gram bladder stone in a 32-year-old male: A case report from the Peruvian Amazon

Abstract

Giant bladder lithiasis is a rare clinical finding, particularly among young adults. We report the case of a 32-year-old male from the Peruvian Amazon who presented with progressive lower urinary tract symptoms, recurrent urinary tract infections, and weight loss over 2 years. Uroimaging revealed a solitary 15×15 cm hyperdense mass occupying the entire bladder cavity. Laboratory studies showed severe anemia, elevated creatinine, and urinary sediment with struvite crystals. Despite repeated evaluations, a timely diagnosis was delayed, leading to bilateral hydroureteronephrosis and renal impairment. The patient underwent open cystolithotomy, which extracted a 2150-gram stone in multiple fragments. Postoperative recovery was uneventful, and histopathology revealed bladder squamous metaplasia without malignancy. Follow-up imaging demonstrated residual bladder wall thickening and decreased renal dimensions. This case highlights the severe complications that can result from neglected bladder lithiasis in vulnerable populations and underscores the need for early urologic evaluation, especially in settings with limited access to healthcare.