Muscle-invasive bladder cancer in a young adult: a case report and a review of the literature

Adenocarcinoma of Urinary Bladder With Distant Metastasis: Huge Fungating Tumor Eroding and Ripping-Off Through Suprapubic Region: A Rare Presentation

Adenocarcinoma of the urinary bladder is an extremely rare entity. It has aggressive behavior and it responds poorly to chemotherapy and radiotherapy. Painless hematuria and passage of clots are mainly common symptoms. Primary bladder adenocarcinoma has a poor prognosis due to its late presentation at an advanced stage. We present here, a rare case report of a 65-year-old male who presented with a huge ulcerative fungating tumor of clinical size 7 x 6 x 5 cm and radiological size 8.6 x 8.1 x 8 cm (exophytic component) and 3.6 x 3.3 x 3 cm (endophytic component) at suprapubic region eroding through pubic bone, rectus muscle and skin with features of lung and inguinal nodes metastasis. Wedge biopsy from fungating growth was suggestive of adenocarcinoma of the urinary bladder of papillary mucin secreting subtype which is also a very rare variant and subtype to get reported. It has a very poor prognosis and only a 6% of survival rate. Keeping all this context, due to poor Eastern Cooperative Oncology Group (ECOG) performance status, huge tumor burden, and advanced presentation of disease, it was suggested by the institutional tumor board, to provide him with the best palliative care management.

Enterovesical fistula secondary to transitional cell carcinoma of the bladder in a 20 years old patient: A rare entity

Bladder cancers are not very common in young people under 20 years, especially with an atypical presentation such as faecaluria due to enterovesical fistula.

This report describes the case of a 20 years old man who was diagnosed with a mass involving the small intestine and bladder during the course of investigations for faecaluria and abdominal pain. Histopathological examination of the biopsies during cystoscopy revealed: muscle invasive transitional cell carcinoma, while the computerized tomography scan had confirmed the enterovesical fistula.

The patient was traited by Radical cystectomy with extended pelvic lymph node dissection and ileocecal resection as ultimate curative treatment.