PMC5264201_01
(a) Magnetic resonance imaging abdomen + pelvis - 61 x 23 x 43 mm sized enhancing polypoidal mass lesion involving anterosuperior wall of bladder on right side with focal loss of fat plane of the mass anteriorly with multiple enlarged pre/paraaortic, bilateral iliac, and inguinal lymph nodes were noted, (b) contrast-enhanced computed tomography abdomen + pelvis - irregular thick wall enhancing area with internal nonenhancing area in anterosuperior wall of bladder with perivesical fat stranding and extension of lesion in the right rectus abdominis muscle (c) Intraoperative photograph (d) postoperatively specimen photograph
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F1
Magnetic resonance imaging abdomen and pelvis of the patient was performed postoperatively which showed approximately 61 x 23 x 43 mm sized enhancing polypoidal mass lesion involving anterosuperior wall of bladder on the right side, the mass appeared hypointense on T1WI and T2WI and showed enhancement on post contrast study, there was focal loss of fat plane of the mass anteriorly suggestive of involvement of perivesical fat with invasion of perivesical fat, bilateral recti and subcutaneous fat present, there was peripheral rim enhancement with central nonenhancing necrotic areas, there was loss of fat plane with uterus and right fallopian tube, multiple enlarged pre/paraaortic, bilateral iliac and inguinal lymph nodes were noted [Figure 1a]. Contrast-enhanced computed tomography abdomen + pelvis showed irregular thick wall enhancing area with internal nonenhancing area in anterosuperior wall of bladder with perivesical fat stranding and extension of lesion in the right rectus abdominis muscle [Figure 1b]. We performed a partial cystectomy [Figure 1c and d], and histological examination of the mass showed xanthomatous cystitis [Figure 2].
Histopathopathological image - showing xanthoma cells with all layers of urinary bladder
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F2
We performed a partial cystectomy [Figure 1c and d], and histological examination of the mass showed xanthomatous cystitis [Figure 2].