Korean J Urol.  2014 Jul;55(7):496-498. 10.4111/kju.2014.55.7.496.

Vesicoenteric Fistula due to Bladder Squamous Cell Carcinoma

• Kang YJ
• Park DJ
• Kim S
• Kim SW
• Lee KS
• Choi NG
• Kim KH

• KMID: 1794581
• DOI: http://doi.org/10.4111/kju.2014.55.7.496

Abstract

Vesicoenteric fistula is a rare complication of bladder squamous cell carcinoma. We report the case of a 70-year-old male who complained of painless, total gross hematuria. Abdominopelvic computed tomography (CT) revealed an approximately 2.7-cm lobulated and contoured enhancing mass in the bladder dome. We performed partial cystectomy of the bladder dome after transurethral resection of the bladder. The biopsy result was bladder squamous cell carcinoma, with infiltrating serosa histopathologically, but the resection margin was free. Postoperatively, follow-up CT was done after 3 months. Follow-up CT revealed an approximately 4.7-cmx4.0-cm lobulated, contoured, and heterogeneous mass in the bladder dome. A vesicoenteric fistula was visible by cystography. Here we report this case of a vesicoenteric fistula due to bladder squamous cell carcinoma.

Keyword

Squamous cell carcinoma; Urinary bladder; Urinary bladder fistula

MeSH Terms

Aged
Carcinoma, Squamous Cell/*complications/pathology/radiography
Fatal Outcome
Humans
Intestinal Fistula/*etiology/radiography
Male
Sigmoid Diseases/*etiology/radiography
Tomography, X-Ray Computed
Urinary Bladder Fistula/*etiology/radiography
Urinary Bladder Neoplasms/*complications/pathology/radiography

Figure

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  FIG. 1 Computed tomography of the lower abdomen showing an approximately 2.7-cm lobulated and contoured enhancing mass in the bladder dome, within a diverticulum (arrow).

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  FIG. 2 An ulcerofungating friable mass measuring 5.5 cm×4.5 cm×1.5 cm. Upon sectioning, firm whitish gray masses were seen.

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  FIG. 3 The bladder tumor was composed of keratin-producing malignant cells (H&E, ×200).

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  FIG. 4 Computed tomography (CT) showing an approximately 4.7-cm×4-cm lobulate, heterogeneous mass in the dome of the bladder (arrow). CT also showed another 2.9-cm×2.3-cm hypodense mass with peripheral rim enhancement in the right upper abdomen.

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  FIG. 5 Cystography showing leakage of contrast medium to the ileum (arrow).

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  FIG. 6 Computed tomography showing a more enlarged mass at the superior aspect of the urinary bladder and noted communication with the sigmoid colon (arrow).

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