Primary adenocarcinoma of the appendix masquerading as a bladder tumor

Appendiceal adenocarcinoma, a rare lesion, is difficult to diagnose preoperatively. The unusual combination of genitourinary symptoms, a fungating adenocarcinoma of the deeper layers of the bladder wall, and an abnormal barium enema resulted in what seems to be the first reported case to be diagnosed preoperatively. Preoperative radiotherapy and radical exenteration of the tumor with ileotransverse colectomy and ureteroileal cutaneous diversion were performed. The patient is well without evidence of recurrence two years later.