Sathish Kumar G1, Haris C. H2, Vaibhav Vikas3, Jatin Soni4
PRESENTATION OF CASE
The first patient is a 30-year-old female who presented with an irregularly fungating growth (Figure 1) just above the anteriorly placed vagina in the area of the exposed urinary bladder. She gives history of surgery for exstrophy bladder at 5 years of age. Since the last six months, she noticed that the swelling in the lower abdomen was prone to ulceration, infection and bleeding and was referred to our center from local hospital.
On examination, labia majora was found to be separated at the mons area. There were no significantly enlarged inguinal lymph nodes. Gross divarication of recti was found. Systemic examination was normal. Secondary sexual characters and breasts were well developed.
X-ray pelvis showed symphysis diastases. Routine laboratory investigations including ultrasound of abdomen and chest x-ray were within normal limits. Contrast-enhanced CT scan of the abdomen and pelvis with CT urogram showed the localised growth from the bladder wall with no ureteric involvement. Iliac/retroperitoneal region showed no significant lymphadenopathy. Both ureters showed moderate dilatation up to the bladder due to narrow orifices that were difficult to locate on the bladder wall. Vaginoscopy revealed a roomy vagina and normal cervix. Biopsy was taken from representative sites from the mass.