case_images: PMC7557901_01
case_images: The first bladder echography showing a thickening of the right lateral wall.
case_images: CRIU2020-8827646.001.jpg
case_images: PMC7557901_01_CRIU2020-8827646.001.jpg
case_images: fig1
case_images: In the emergency room, an abdominal and pelvic ultrasound showed a thickening of the right lateral wall of the bladder with mild right side hydronephrosis (Figure 1).
case_images: On the left: microscopic view of the bladder biopsy showing a proliferation of polygonal malignant cells and cylindrical cells with multiple necrotic areas; on the right: large polygonal cells with a dark and irregular nucleus and frequent metastases.
case_images: CRIU2020-8827646.002.jpg
case_images: PMC7557901_01_CRIU2020-8827646.002.jpg
case_images: fig2
case_images: Muscular invasion was documented with multiple necrotic areas (Figure 2).
case_images: Malignant cells showing high positivity for CD56 marker on immunohistochemistry.
case_images: CRIU2020-8827646.003.jpg
case_images: PMC7557901_01_CRIU2020-8827646.003.jpg
case_images: fig3
case_images: Immunohistochemistry showed high positivity for CD56 marker and synaptophysin, minor and heterogenic positivity for cytokeratin 7, and negativity for cytokeratin 20 and CDX2 (Figures 3-5).
case_images: Malignant cells showing high positivity of synaptophysin marker on immunohistochemistry.
case_images: CRIU2020-8827646.004.jpg
case_images: PMC7557901_01_CRIU2020-8827646.004.jpg
case_images: fig4
case_images: Immunohistochemistry showed high positivity for CD56 marker and synaptophysin, minor and heterogenic positivity for cytokeratin 7, and negativity for cytokeratin 20 and CDX2 (Figures 3-5).
case_images: Malignant cells showing minor and heterogenic positivity for cytokeratin 7 marker on immunohistochemistry.
case_images: CRIU2020-8827646.005.jpg
case_images: PMC7557901_01_CRIU2020-8827646.005.jpg
case_images: fig5
case_images: Immunohistochemistry showed high positivity for CD56 marker and synaptophysin, minor and heterogenic positivity for cytokeratin 7, and negativity for cytokeratin 20 and CDX2 (Figures 3-5).
case_images: Pelvic scan showing a 6 x 3.5 cm mass of the anterior and right lateral wall of the bladder with diffuse infiltration of the bladder fat.
case_images: CRIU2020-8827646.006.jpg
case_images: PMC7557901_01_CRIU2020-8827646.006.jpg
case_images: fig6
case_images: A 6 x 3.5 cm mass of the anterior and right lateral walls of the bladder was identified, with diffuse infiltration of the perivesical fat and multiple necrotic iliac lymph nodes bilaterally (Figure 6).
case_images: Pelvic scan showing the evolution of the bladder tumor.
case_images: CRIU2020-8827646.007.jpg
case_images: PMC7557901_01_CRIU2020-8827646.007.jpg
case_images: fig7
case_images: Four months later, after the completion of four cycles of chemotherapy, the patient underwent new assessment for disease extension (Figure 7).