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RESIDENT’S CORNER

T4 urothelial carcinoma in undiagnosed closed bladder exstrophy in a post-menopausal female

Brian J. McArdle, Patricia Vidal, Sarah P. Psutka, Courtney M.P. Hollowell

Division of Urology, Department of Surgery, Cook County Health and Hospitals System, Chicago, Illinois, USA
Address correspondence to Dr. Brian J. McArdle, 1900 W. Polk Street, Suite 465, Chicago, IL 60612 USA

Canadian Journal of Urology 2018, 25(1), 9214-9216.

Abstract

It is rare to see an adult presenting with exstrophy of the bladder. Malignant conversion in exstrophy occurs in 4%, with adenocarcinoma as the most common histopathology. We report the first case of metastatic high grade urothelial carcinoma with squamous and sarcomatoid differentiation arising from undiagnosed, closed bladder exstrophy in a female at advanced age with associated bilateral deep vein thrombosis and clot retention. The patient developed clinical progression of disease despite neoadjuvant gemcitabine-cisplatin and salvage (or palliative) radiotherapy. To the best of our knowledge, this is the first reported case of a primary urothelial malignancy in occult bladder exstrophy.

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