Vesicocutaneous fistula secondary to invasive bladder squamous cell carcinoma: an unusual initial presentation

We report a rare presentation of vesicocutaneous fistula associated with invasive squamous cell carcinoma. An elderly man presented with urinary leakage from an anterior abdominal wall wound and features of sepsis, preceded by progressive suprapubic swelling that spontaneously ruptured. CT imaging demonstrated a fistulous tract between the bladder and abdominal wall with features of locally advanced malignancy and appearances suspicious for metastatic disease. Histopathology confirmed squamous carcinoma; however, due to limited sampling, it was not possible to definitively distinguish between a primary bladder origin and cutaneous malignancy. Conservative management was adopted. This case highlights the importance of individualised patient-centred care.