title: Delayed spontaneous perforation of urinary bladder with intraperitoneal seeding following radical transurethral resection of invasive urothelial cancer: a case report.
abstract: BACKGROUND
  Transurethral resection of bladder tumor (TURBT) may be applicable for the treatment of deeply invasive tumors in high-risk patients who are not suitable candidates for radical cystectomy. Intraperitoneal perforation is much less common, however, bladder wall perforation is still a cause for concerns because after perforation several studies have been reported to have peritoneal or abdominal metastases.
  
  
  METHODS
  An 84-year-old female patient with multiple large enhancing masses in the urinary bladder underwent radical TURBT to remove the deeply invasive tumors because she was not a suitable candidate for a major operation. Microscopic examination of the resected specimen confirmed the muscle invasive urothelial carcinoma with partial invasion into the perivesical fat tissue. She visited again 6 months later after the operation complaining abdominal distension. Computed tomography showed perforation of urinary bladder with intraperitoneal seeding and adnexa metastasis.
  
  
  CONCLUSIONS
  Radical TURBT could be associated with delayed perforation of urinary bladder and intraperitoneal seeding.
authors.forename: Jae Heon
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Urology, Soonchunhyang University College of Medicine, Hospital, 59, Daesagwan-ro, Yongsan-gu, Seoul 140-743, South Korea. wonjya@schmc.ac.kr.
authors.forename: Won Jae
authors.initials: WJ
authors.lastname: Yang
mesh_terms: D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000473:pathology / Q000601:surgery*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D009361:Neoplasm Invasiveness; D009366:Neoplasm Seeding; D010534:Peritoneal Neoplasms / Q000556:secondary; D012422:Rupture, Spontaneous; D013997:Time Factors; D014521:Urethra / Q000601:surgery*; D001743:Urinary Bladder / Q000293:injuries*; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery*