PMC8063770_01
Computed tomography (CT) scan of the pelvis with intravenous contrast: (a) Axial CT image of the pelvis acquired during the portal venous phase demonstrates irregular thickening of the right anterolateral urinary bladder wall (red arrow) and an enlarged prostate bulging into the bladder base (white arrow). (b) Axial and (c) sagittal CT images of the inguinal region reveal a heterogeneous, enhancing soft tissue mass in the right inguinal canal, inseparable from the right anterolateral aspect of the urinary bladder wall (red arrow). There is a moderately sized hydrocoele in the right scrotum (yellow arrow).
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Computed tomography (CT) scan of the abdomen and pelvis demonstrated a 6.5 cm x 5.4 cm x 6.4 cm enhancing soft tissue mass in the right inguinal canal, inseparable from the anterolateral aspect of the urinary bladder with an accompanying hydrocoele (Figure 1).
(a) Coronal 18-fluoro-D-glucose positron emission tomography/computed tomography (PET/CT) fusion image shows intense hypermetabolic activity (standardised uptake value [SUV] max 28) in the right inguinal mass (yellow arrow). A few metabolically active nodules were present in both lungs, of which one is shown in the same picture (white arrow). (b) Axial PET/CT fusion image demonstrating multiple metabolically active lymph nodes in the pelvis (white arrows) with SUV max of 10.
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A 2-deoxy-2-[fluorine-18] fluoro-D-glucose integrated with CT (18F-FDG positron emission tomography [PET]/CT) scan demonstrated a hypermetabolic mass in the right inguinal region, with continuous extension into the urinary bladder lumen (Figure 2).
Histopathological diagnosis of primary squamous cell carcinoma of the urinary bladder (a) Hematoxylin and eosin stain; 400 x magnification indicating well differentiated squamous cells (red arrow). (b) The Ck-7 stain is positive (yellow arrow). (c) The P40 stain is also positive in the tumour cells (white arrow). The histopathology confirms the diagnosis of primary squamous cell carcinoma of the urinary bladder.
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Ultrasound-guided biopsy of the inguinal mass was consistent with SCC (Figure 3).