Squamous cell carcinoma in exstrophy of the bladder

Abstract

Exstrophy of the bladder is a rare congenital anomaly with an incidence of about 1 per 50,000 newborns. The malignant potential of the exstrophied bladder mucosa is well known; 95% are adenocarcinomas, and 3% to 5% are squamous cell carcinomas. Most of the malignant tumors (60%) associated with an exstrophy of the bladder occur during the fourth and fifth decades of life. Of the remaining, about 20% each occur after 60 years and before 40 years. Here we present a case in which squamous cell carcinoma developed in an unrepaired exstrophy of the bladder. We present the management of the case and a brief review of the literature.

Keywords: Bladder exstrophy; Squamous cell carcinoma; Urinary bladder neoplasms.

FIG. 1

Preoperative photograph of the patient showing the hemispherical growth with an irregular surface.

FIG. 2

Intraoperative photograph showing the skin incision used for the modified groin flap.

FIG. 3

Immediate postoperative photograph showing the abdominal wall defect covered with a modified groin flap.

FIG. 4

Photograph of the patient after 5 months of follow-up showing a well-healed modified groin flap and excellent take of the skin graft at the secondary defect site.

FIG. 5

Histopathological picture of the case (H&E, ×400) showing well-differentiated squamous cell carcinoma.