Aden carcinomas account for less than 2% of primary bladder cancers. In some situations, bladder tumors especially aden carcinomas has got unusual clinical presentations. A 76 year old female with diabetes mellitus was presented to the emergency room because of fever, abdominal pain and erithem of suprapubic region and after physical examination abdominal wall abscess was suspected and the patient underwent surgery. After drainage of abscess, the surgeon noted extending of abcess to pelvic cavity with involvement of bladder wall and adjacent organs. Urologic consultation was performed and frozen sections were obtained from involving portions of the bladder that revealed malignancy. Thus eventually, radical cystectomy and anterior pelvic exentration and bilateral ureterosigmoidostomy were performed. The patient was discharged after ten days with good general condition. Definitive pathological and immunohistochemistry result was reported as primary bladder adenocarcinoma with invasion to abdominal muscles. To date, the case of bladder adenocarcinoma with initial presentation of abdominal wall abcess has not been reported and our patient is thoroughly exclusive and significant case because of its unusual presentation and type of performed procedure in unprepared bowel preoperatively.
SOURCE : URMIA MED J 2012: 23(1): 91 ISSN: 1027-3727