[Hematuria: an initial sign of cecal carcinoma]

A 79-year-old female was seen with hematuria, cystoscopy showed a non-papillary, broad-based tumor arising from the right anterolateral wall of the bladder. Transurethral biopsy revealed adenocarcinoma. Pelvic CT scanning revealed that the tumor extended from the bladder wall to the wall of the ileo-caecal intestine. Gastrointestinal series revealed no abnormal findings although the cecum could not be visualized clearly, and we could not distinguish whether the primary site was the bladder or intestine. Surgical exploration was performed. The main tumor seemed to arise from the cecum, extended downward and invaded the bladder wall. Right hemicolectomy and en bloc partial cystectomy were performed. The final diagnosis was adenocarcinoma of the cecum invading the bladder. We could find no reports on adenocarcinoma of the cecum in which hematuria was the initial symptom, as in this case, in Japan.