PMC9970112_01
A clinical photograph showing the bladder mass
cureus-0015-00000034308-i01.jpg
PMC9970112_01_cureus-0015-00000034308-i01.jpg
FIG1
On examination, there is an approximately 12 cm x 10 cm sized, an exophytic irregular mass that was non-tender and bled on touch and occupies the entire exposed urinary bladder surface (Figure 1).
A CT scan showing the mass arising from bladder exstrophy
cureus-0015-00000034308-i02.jpg
PMC9970112_01_cureus-0015-00000034308-i02.jpg
FIG2
Contrast-enhanced computed tomography of the abdomen and pelvis revealed a soft tissue mass protruding from a large inferior abdominal wall lesion of size 5.3 cm with widened pubic symphysis and an absent urinary bladder, consistent with bladder exstrophy (Figure 2).
Wide excision of the bladder mass with a 1 cm margin
cureus-0015-00000034308-i03.jpg
PMC9970112_01_cureus-0015-00000034308-i03.jpg
FIG3
Subsequently, a radical cystectomy was carried out with wide local skin excision with a 1 cm margin of resection (Figure 3), along with an ileal conduit.
Left anterolateral thigh flap (arrow)
cureus-0015-00000034308-i04.jpg
PMC9970112_01_cureus-0015-00000034308-i04.jpg
FIG4
After a significant local resection, the abdominal defect (Figure 4) of approximately 13 cm x 11 cm was covered with a pedicle of the anterolateral thigh flap based on perforators of descending branches of the lateral circumflex femoral artery (Figure 5).
The defect is covered with a pedicle of the anterolateral thigh flap based on perforators of the descending branches of the lateral circumflex femoral artery
cureus-0015-00000034308-i05.jpg
PMC9970112_01_cureus-0015-00000034308-i05.jpg
FIG5
After a significant local resection, the abdominal defect (Figure 4) of approximately 13 cm x 11 cm was covered with a pedicle of the anterolateral thigh flap based on perforators of descending branches of the lateral circumflex femoral artery (Figure 5).
The defect site covered after the surgery
cureus-0015-00000034308-i06.jpg
PMC9970112_01_cureus-0015-00000034308-i06.jpg
FIG6
The flap site after the surgery
cureus-0015-00000034308-i07.jpg
PMC9970112_01_cureus-0015-00000034308-i07.jpg
FIG7
Histopathological (hematoxylin and eosin stain) examination of the resected mass (tumor) at low power magnification (10X) (arrow)
cureus-0015-00000034308-i08.jpg
PMC9970112_01_cureus-0015-00000034308-i08.jpg
FIG8
The specimen of the bladder mass was sent for histopathological examination (HPE), which was suggestive of signet ring cell adenocarcinoma under low (Figure 8) and high power magnification (Figure 9).
Histopathological (hematoxylin and eosin stain) examination of the resected mass (tumor) on high power magnification (40X) (arrow)
cureus-0015-00000034308-i09.jpg
PMC9970112_01_cureus-0015-00000034308-i09.jpg
FIG9
The specimen of the bladder mass was sent for histopathological examination (HPE), which was suggestive of signet ring cell adenocarcinoma under low (Figure 8) and high power magnification (Figure 9).