Epidemiological, Clinical and Histopathological Profile of Squamous Cell Carcinoma of the Bladder in Guinea

Introduction: Bladder squamous cell carcinoma, closely associated with endemic urinary schistosomiasis in sub-Saharan Africa, presents distinctive characteristics. This study aimed to describe the sociodemographic, clinical, and histopathological profile of this disease in Guinea. Methodology: A retrospective descriptive study was conducted at Conakry University Hospital between January 2015 and December 2024, including 35 patients with histologically confirmed bladder squamous cell carcinoma. Sociodemographic, clinical, cystoscopic, and histopathological data were analyzed. Results: The mean age was 57.4 years with predominance in the 60 - 69 age group (42.86%). Female predominance was observed (male-to-female ratio 0.59:1). Freshwater bathing was the main risk factor (80%). Hematuria was the primary presenting symptom (88.57%). Diagnosis was late, with 57.14% of patients having ECOG ≥ 3 and 54.29% presenting with renal failure. Tumors were predominantly solid (85.71%), sessile (91.43%), and multifocal (88.57%), with large size (median 7.8 cm) and ureteral orifice involvement (71.43%). Histological analysis revealed 91.43% muscle-invasive tumors and 97.14% high-grade tumors. Schistosoma haematobium eggs were identified in 34.29% of specimens. Conclusion: Bladder squamous cell carcinoma is associated with vesical schistosomiasis in Guinea and characterized by late diagnosis at the muscle-invasive stage. Strengthening schistosomiasis prevention and improving early detection are essential to enhance prognosis.