case_images: PMC9970112_01
case_images: A clinical photograph showing the bladder mass
case_images: cureus-0015-00000034308-i01.jpg
case_images: PMC9970112_01_cureus-0015-00000034308-i01.jpg
case_images: FIG1
case_images: 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).
case_images: A CT scan showing the mass arising from bladder exstrophy
case_images: cureus-0015-00000034308-i02.jpg
case_images: PMC9970112_01_cureus-0015-00000034308-i02.jpg
case_images: FIG2
case_images: 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).
case_images: Wide excision of the bladder mass with a 1 cm margin
case_images: cureus-0015-00000034308-i03.jpg
case_images: PMC9970112_01_cureus-0015-00000034308-i03.jpg
case_images: FIG3
case_images: 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.
case_images: Left anterolateral thigh flap (arrow)
case_images: cureus-0015-00000034308-i04.jpg
case_images: PMC9970112_01_cureus-0015-00000034308-i04.jpg
case_images: FIG4
case_images: 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).
case_images: 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
case_images: cureus-0015-00000034308-i05.jpg
case_images: PMC9970112_01_cureus-0015-00000034308-i05.jpg
case_images: FIG5
case_images: 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).
case_images: The defect site covered after the surgery
case_images: cureus-0015-00000034308-i06.jpg
case_images: PMC9970112_01_cureus-0015-00000034308-i06.jpg
case_images: FIG6
case_images: The flap site after the surgery
case_images: cureus-0015-00000034308-i07.jpg
case_images: PMC9970112_01_cureus-0015-00000034308-i07.jpg
case_images: FIG7
case_images: Histopathological (hematoxylin and eosin stain) examination of the resected mass (tumor) at low power magnification (10X) (arrow)
case_images: cureus-0015-00000034308-i08.jpg
case_images: PMC9970112_01_cureus-0015-00000034308-i08.jpg
case_images: FIG8
case_images: 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).
case_images: Histopathological (hematoxylin and eosin stain) examination of the resected mass (tumor) on high power magnification (40X) (arrow)
case_images: cureus-0015-00000034308-i09.jpg
case_images: PMC9970112_01_cureus-0015-00000034308-i09.jpg
case_images: FIG9
case_images: 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).