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British Journal of Radiology (2006) 79, e8-e11
© 2006 British Institute of Radiology
doi: 10.1259/bjr/56199075
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Complete eversion and prolapse of bladder concurrent with primary adenocarcinoma

Y H Kim, MD 1 D J Sung, MD, PhD 1 S B Cho, MD 1 K B Chung, MD 1 S H Cha, MD 1 H S Park, MD 2 and J W Um, MD 3

Departments of 1Radiology 2Urology and 3Surgery, Korea University College of Medicine, Anam Hospital, Korea University, College of Medicine, #126-1, 5-Ka Anam-dong, Sungbuk ku, Seoul 136-705, Korea


Figure 1
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  		Figure 1. (a) Sagittal T2 weighted MR image of the pelvis obtained with the patient at rest shows a protruding mass with heterogeneous signal intensity, which was confirmed as the everted and prolapsed bladder in the external genital area. The omental fat (black arrows) is herniated into the centre of the mass and the everted bladder (white arrows) is seen inferiorly with heterogeneous signal intensity at the periphery of the mass. A small amount of fluid (curved arrow) is seen between the everted bladder and the herniated omental fat. The uterus distended by saline (*) descends and lies posterior to the pubis. The cervix does not prolapse through the vagina (arrowheads). (b) Coronal T2 weighted MR image of the pelvis obtained with the patient at rest shows the everted and prolapsed bladder between the thighs. Both ureters (arrows) are dilated and stretched below the symphysis pubis. The uterus distended by saline (*) has a lower position in the pelvis. (c) Gadolinium-enhanced T1 weighted image shows diffuse thickening of the everted bladder wall (arrows) with contrast enhancement at the periphery of the protruding mass between the thighs. Herniated omental fat of heterogeneously high signal intensity (curved arrow) is seen in the centre of the mass without contrast enhancement.

 

Figure 2
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  		Figure 2. Colour photograph shows an erythematous mass covered with whitish plaques in the external genital area. Two orifices(arrows), which were confirmed as ureteral orifices, are exposed externally at the base of the mass with 5 Fr ureteral catheters.

 

Figure 3
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  		Figure 3. Tubography through the ureteral catheters shows stretched ureters below the symphysis pubis with bilateral hydronephroureterosis.

 

Figure 4
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  		Figure 4. Colour photograph of the gross surgical specimen shows a large mass partially covered by everted and thickened bladder wall(arrows). The central portion of the mass is herniated omental fat (*). The tumour (curved arrows) reveals a diffuse infiltrative pattern in the thickened wall.

 




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