Due to the conspicuous morphology of the deformity and the fact that primary reconstruction is typically performed in infancy, untreated bladder exstrophy in adults is infrequent. An adult presenting with bladder exstrophy is quite uncommon. We present a 32-year-old man with a bladder mass that existed since birth. He complained of an unpleasant discharge from the mass upon presentation, and on examination, a mass was seen on the urinary bladder's exposed surface, coupled with penile epispadias, a deformed scrotum, and undersized bilateral testicles. Ultrasonography of the kidneys, ureters and urinary bladder (USG KUB), contrast-enhanced computed tomography (CECT) of the abdomen and pelvis, and mass biopsy were all used to investigate the patient. The patient was found to have signet ring adenocarcinoma of the urinary bladder. A radical cystectomy with an anterolateral thigh flap was performed. The clinical and radiological characteristics, treatments, and results of this uncommon presentation are discussed in this case report.