A Case of Urothelial Carcinoma With Squamous Differentiation of the Bladder, Infiltrating the Small Intestine and Rectus Abdominis, Treated With the Use of a Short Gracilis Myocutaneous Flap

Q4 Medicine

IJU Case Reports Pub Date : 2025-07-21 DOI:10.1002/iju5.70077

Kazuto Imai, Norihiko Masuda, Tatsuya Hazama, Kanji Nagahama, Takashi Ito, Takakazu Matsushita, Yoko Muneta, Tadashi Inoue, Toshiya Akao

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Abstract

Introduction

Squamous differentiation (SD) occurs in up to 20% of muscle invasive bladder cancers.

Case Presentation

An 85-year-old man with an intrapelvic mass invading the bladder, small intestine, and rectus abdominis presented to our department. Cystoscopy showed a necrotic mass at the dome of the bladder. Histopathological examination of specimens from transurethral resection indicated squamous cell carcinoma. Radical cystectomy with resection of the small intestine and rectus abdominis, and reconstruction of the abdominal wall using a left short gracilis myocutaneous flap was performed. The histopathology showed squamous cell carcinoma and urothelial carcinoma (UC) components; findings consisted of UC with SD. The patient received appropriate flap management and treatment for postoperative complications and was discharged on postoperative Day 100.

Conclusion

To our knowledge, this is the first report of an invasive bladder cancer with SD treated with the use of a short gracilis myocutaneous flap.

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尿路上皮癌伴膀胱鳞状分化，浸润小肠及腹直肌1例，短股薄肌肌皮瓣治疗

鳞状分化（SD）发生在高达20%的肌肉浸润性膀胱癌。病例介绍：一名85岁男性病患因盆腔内肿物侵入膀胱、小肠及腹直肌就诊。膀胱镜检查显示膀胱穹窿处有坏死肿块。经尿道切除标本的组织病理学检查显示为鳞状细胞癌。行根治性膀胱切除术，切除小肠和腹直肌，并用左股薄肌短肌皮瓣重建腹壁。组织病理学表现为鳞状细胞癌和尿路上皮癌（UC）成分；结果包括UC伴SD。患者接受了适当的皮瓣处理和术后并发症治疗，于术后第100天出院。结论：据我们所知，这是首例使用短股薄肌肌皮瓣治疗浸润性膀胱肿瘤伴SD的报道。

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