case_images: PMC11760787_01
case_images: Computed tomography (CT), coronal reconstructed images (A) pre-contrast, (B) arterial phase, (C) portal venous phase and (D) delayed images revealed a right lower abdominal mass (arrows) extending from the urinary bladder through the right superior and lateral wall, breaching the bladder wall and almost filling the lumen. There is associated distal ileal loop inflammation, fistulous formation between bladder and bowel loops and air-filled cavity within the mass (notched white arrows), and intraabdominal adenopathy and calcification (white chevron).
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case_images: Additionally, the scan showed abdominal lymphadenopathy and calcification as seen in Fig. 1, Fig. 2.
case_images: Coronal reconstructed delayed images post-IV contrast show mild hydronephrosis with ipsilateral hydro ureter image (H) and (I) white bent arrows. The ureter could be traced down to just above the iliac crest level where there is a large mass-like lesion of matted bowel loops appearing to be extending into the urinary bladder lumen via a breech at the fundus of the bladder. Air is seen within the bladder lumen. Post-oral contrast the images confirm the presence of fistulous communication between bladder and bowel loops as well as bowel loops and the focal air collection within the matted structures image (J) notched arrows.
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case_images: Cytology of the ascetic fluid showed haemorrhagic background and clusters of atypical hyperchromatic cells forming glandular/ductal structures.
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case_images: A minimal amount of serosanguinous ascitic fluid was noted and collected for cytological analysis, as shown on Fig. 4, which corresponds to Stage IV under the Mayo Staging system.
case_images: Gross sections of the complete resected tumor which included partial cystectomy, segmental bowel resection, and right salpingo-opherectomy. (Red arrow) - bowel, (yellow arrow) - urinary bladder, (white arrow) - tumor, and (black arrow) - ovary. The cut section of the tumor was solid to cystic in consistency, with mucoid material. It involved the urinary bladder and ovary. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)
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case_images: The urachal remnant and median umbilical ligaments were excised, segmental ileal resection, partial cystectomy with a 1 cm margin, and right salpingo-opherectomy was done, as seen in Fig. 5.
case_images: Histopathology of the resected specimen showed a malignant neoplasm predominantly showing neoplastic glands floating on mucin pools (red arrow). Other sections showed moderately differentiated glands (black arrow). (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)
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