• Liangliang Li, Kun Liu, Xueping Ma, Yameng Wu, Changxi Wang, and Yangang Wang.
• Department of Urology, The Fuyang Hospital of Anhui Medical University, Fuyang, China.
• Medicine (Baltimore). 2024 Aug 9; 103 (32): e39187e39187.

RationaleBladder urothelial carcinoma (UC) is a common urinary system tumor that is generally diagnosed by cystoscopy combined with pathological biopsy. However, complete exophytic UC of the bladder is very rare and difficult to diagnose. Early diagnosis and accurate identification of such tumors, followed by aggressive surgical treatment, is essential for the management of these patients.Patient ConcernsAn 84-year-old man was admitted to the hospital with dysuria, a poor diet, and significant weight loss.DiagnosisPelvic computed tomography and magnetic resonance imaging revealed an exteriophytic round mass on the right lateral wall of the bladder. Cystoscopy revealed a necrotic mass on the right lateral wall of the bladder cavity, and no tumor cells were found following the biopsy. The tumor was removed via partial cystectomy, and the pathological result indicated high-grade muscle-invasive UC.InterventionsThe patient refused radical cystectomy and underwent laparoscopic partial cystectomy plus pelvic lymph node dissection followed by cisplatin plus gemcitabine chemotherapy.OutcomesThe patient's mental state and appetite were significantly improved after the urinary tube was removed 1 week after surgery. His general state was significantly improved after 1 month of follow-up but died of acute cerebral infarction 3 months after surgery.LessonsUC of the bladder may grow completely out of the bladder without symptoms such as gross hematuria; thus, early diagnosis is difficult. For high-risk individuals, regular imaging tests may help to detect tumors early. Partial cystectomy is a reliable surgical modality for bladder preservation in such patients.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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