A 67-year-old woman presented with obstructive urinary symptoms and pain in abdomen. No hematuria was noted. CT scan and USG pelvis and abdomen showed peripheral enhancing lesion at bladder neck and along urethra suggestive of infective/inflammatory aetiology. Heterogeneously enhancing nodular thickness was seen along anterior bladder wall along with abdominal and inguinal lymphadenopathy. Vesicourethroscopy examination showed tight urethra; complete periurethral induration with mass involving trigone of bladder, diverticula was also noted. Biopsy of tumour was done and a diagnosis of adenocarcinoma was made.Following this, the patient received two chemotherapy cycles. CT abdomen after 2 nd chemotherapy showed residual urinary bladder wall thickening with invasion of vagina and vesico vaginal fistula. Patient underwent bladder exenteration surgery with hysterectomy and bilateral salpingo-oophorectomy with ureteric implantation into rectum. Postoperative period was uneventful.
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