Background: Stone – associated squamous cell carcinoma is rare unlike other urothelial tumours, and it is a disease of neglect seen in the elderly harboring stone for a long time. It is usually aggressive with fatal outcome. Patients and Methods: The study reviewed all patients with stone – associated squamous cell carcinoma of the urinary bladder managed in the University of Maiduguri Teaching Hospital, State Specialist Hospital Maiduguri, and Specialist Hospital Damaturu between January 2005 and December 2014. Emergency presentations were resuscitated with analgesics, antibiotics, intravenous fluids, blood transfusion, and hemodialysis where necessary. Operable patients had surgery under general anesthesia. Results: A total of 13 patients were studied age ranged from 33 – 88 years, with a mean of 69.08 years, and male to female ratio of 3.33: 1. Duration of symptoms ranged from 2 – 27 years. Complications at presentations were UTI in 92.31%, anemia in 84.62%, impaired renal function in 61.54%, and vesico- cutaneous fistula in 15.38%. The clinical stages (Marshall’s) at presentation were stage 2 in 15.38%, stage 3 in 53.8, and stage 4 in 23.08%. Histology revealed squamous cell carcinoma in all patients, 38.46% were moderately differentiated, and 30.77% poorly differentiated. The postoperative complications were acute renal failure in 23.08%, and metabolic acidosis in 30.77%. There were 23.08% mortalities. The one year survival rate was 46.15%. Conclusion: Stone – associated SCC occur in patients with long - standing bladder stone that had no access to healthcare or neglected.
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