Primary urinary bladder adenocarcinoma with vaginal invasion

Primary urinary bladder adenocarcinoma is not a common tumor, it comprises between 0.5 and 2% of all bladder tumors. It has been linked to bladder exstrophy, chronic irritation, and pelvic lipomatosis. Next, the case of a 62-year-old female patient with primary urinary bladder adenocarcinoma and vaginal wall invasion is presented.

Pelvic lipomatosis associated with bilateral obstructive uropathy and proliferative cystitis

Pelvic lipomatosis is a rare benign entity characterised by excessive deposition of adipose tissue in the perirectal and perivesical spaces. We describe a 43-year-old man with bilateral distal ureteral obstruction secondary to pelvic lipomatosis with concomitant proliferative cystitis resulting in severe hydronephrosis. We performed urinary diversion with percutaneous nephrostomy tube insertion to prevent further renal impairment. The patient was advised close follow-up to monitor the increased risk of bladder adenocarcinoma transformation observed in patients with cystitis glandularis. This report, compliant with the CARE (CAse REport) guidelines for clinical case reporting, presents another case of pelvic lipomatosis associated with acute kidney failure, bilateral hydronephrosis and proliferative cystitis without urodynamic evidence of bladder outlet obstruction that may serve to guide urologists in managing patients with a similar profile.

A Case of Incidentally Detected Bladder Lipoma and a Review of the Literature

Background: Lipomas are benign fatty tumors made of fat tissue. Bladder lipomas are extremely rare. For this reason, it is necessary to be aware of the imaging features when incidentally detected in imaging. Case Report: In the abdominal computed tomography (CT) performed as part of the follow-up examination of a 43-year-old patient, who had undergone surgery for adrenal adenoma five years earlier, a 14x9x8 mm smoothly marginated, ovoid-shaped, hypodense mass lesion with a homogeneous internal structure was detected in the anterior bladder wall. The pre-contrast density of the lesion was measured as -105 HU. The magnetic resonance imaging performed one year after the CT examination revealed a 14x9x8 intramural mass in the bladder wall, showing protrusion toward the lumen. The group was observed to be markedly hypointense on fat-suppressed T1 and T2-weighted images and considered consistent with a bladder lipoma. Discussion: Bladder lipomas are benign lesions that can vary in clinical presentations but usually cause hematuria. The differential diagnosis of bladder lipomas includes other mesenchymal rare benign tumors that can arise from the urinary bladder submucosal layer, including leiomyoma, hemangioma, plasmacytoma, fibroma, and neurofibroma, in imaging bladder lipomas present as homogeneous lesions containing macroscopic fat. Only the liposarcoma and pelvic lipomatosis could also show similar features. The less differentiated liposarcomas tend to present more heterogeneous enhancement, irregular-shaped margins, and infiltrative behavior. Also, appropriate multiplanar reconstructions may allow the radiologist to determine it is an extravesical pelvic lipomatosis. Conclusion: Using CT and MRI, these lesions rich in adipose tissue can be distinguished from other lesions, and their diagnosis can be made to a great extent. However, a histopathological examination is required for a definitive diagnosis.