case_images: PMC11802188_01
case_images: Contrast CT showing mass lesion arising from the left dome of the bladder.
case_images: cureus-0017-00000077095-i01.jpg
case_images: PMC11802188_01_cureus-0017-00000077095-i01.jpg
case_images: FIG1
case_images: Following a comprehensive series of diagnostic tests, including a complete blood picture, complete urine examination, renal function tests, liver function tests, and abdominal ultrasonography, the findings revealed the presence of blood and proteins in urine, severe anemia with a hemoglobin level of 6.1 mg/dl for which the patient had undergone multiple blood transfusions, while a CT urogram identified an intense, heterogeneously enhancing mass lesion originating from the left dome of the urinary bladder (Figure 1).
case_images: Intraoperative image showing (i) the clot, (ii) hematoma, (iii) bladder tumor, and (iv) rectus sheath
case_images: cureus-0017-00000077095-i02.jpg
case_images: PMC11802188_01_cureus-0017-00000077095-i02.jpg
case_images: FIG2
case_images: Under general anesthesia, following scopy, a cystostomy was performed at the dome, targeting the left side (Figure 2).
case_images: Post Partial Cystectomy Specimen
case_images: cureus-0017-00000077095-i03.jpg
case_images: PMC11802188_01_cureus-0017-00000077095-i03.jpg
case_images: FIG3
case_images: A complete tumor excision was achieved (Figure 3), followed by closure in layers.
case_images: a) Histopathology of the specimen showing spindle shaped myofibroblasts proliferation with no signs of necrosis b) Immunohistochemistry image showing strong positivity for ALK-1.
case_images: cureus-0017-00000077095-i04.jpg
case_images: PMC11802188_01_cureus-0017-00000077095-i04.jpg
case_images: FIG4
case_images: Histopathology of the specimen revealed an infiltrating lesion characterized by spindle cell proliferation (Figure 4), with samples from the base indicating involvement of the muscularis propria.