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T4 urothelial carcinoma in undiagnosed closed bladder exstrophy in a post-menopausal female
Division of Urology, Department of Surgery, Cook County Health and Hospitals System, Chicago, Illinois, USA
Feb  2018 (Vol.  25, Issue  1, Pages( 9214 - 9216)
PMID: 29524978


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  • It is rare to see an adult presenting with exstrophy of the bladder. Malignant conversion in exstrophy occurs in 4%, with adenocarcinoma as the most common histopathology. We report the first case of metastatic high grade urothelial carcinoma with squamous and sarcomatoid differentiation arising from undiagnosed, closed bladder exstrophy in a female at advanced age with associated bilateral deep vein thrombosis and clot retention. The patient developed clinical progression of disease despite neoadjuvant gemcitabine-cisplatin and salvage (or palliative) radiotherapy. To the best of our knowledge, this is the first reported case of a primary urothelial malignancy in occult bladder exstrophy.