Vesicocutaneous fistula secondary to invasive bladder squamous cell carcinoma: an unusual initial presentation.
Bilal Ahmad, Ahmed Malik, Peter Brown et al.
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Case in brief
An elderly man presented with urinary leakage from an abdominal wound and signs of sepsis, following a progressive suprapubic swelling that ruptured. CT imaging revealed a fistulous tract between the bladder and abdominal wall, indicating locally advanced malignancy. Histopathology confirmed squamous cell carcinoma, but limited sampling prevented a definitive origin distinction. Conservative management was implemented.
What made this case unusual
The case is notable for the presentation of a vesicocutaneous fistula as an initial sign of invasive squamous cell carcinoma, which is an atypical manifestation of this malignancy.
Diagnostic / clinical pearl
Clinicians should consider the possibility of malignancy in patients presenting with urinary leakage and abdominal wall issues, particularly when accompanied by signs of sepsis.
Why it matters
This case underscores the need for individualized patient care and the importance of thorough diagnostic evaluation in atypical presentations of malignancy.