{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T00:03:40Z","timestamp":1794528220329,"version":"4.9.1"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T00:00:00Z","timestamp":1633564800000},"content-version":"vor","delay-in-days":279,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006378","name":"Universitas Indonesia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006378","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Bladder exstrophy is a rare congenital anomaly while, bladder adenocarcinoma mucinous type is a rare type of bladder cancer, with aggressive behavior and inadequate response to radiation and chemotherapy. In extremely rare cases, untreated bladder exstrophy could transform into bladder mucinous adenocarcinoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We report a case of a 41-year-old male with untreated bladder exstrophy that transformed into mucinous adenocarcinoma. The patient also had epispadias and a right inguinal hernia. Joint procedures were conducted to perform radical cystectomy, total penectomy and W-Pouch continent urostomy, inguinal hernia repair, osteotomy, and keystone and scrotal flap by split-thickness skin graft (STSG) for wound closure. The patient progressed well after surgery, two months after initial procedure, nephrostomies were conducted due to pouches stenosis. Due to the government's limited transportation and lockdown policy, as the Covid-19 pandemic occurred, the patient could not come to the hospital for routine follow-up and died nine-month after surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical discussion<\/jats:title>\n                    <jats:p>Bladder exstrophy is one of the risk factors of bladder cancer. Transformation of bladder exstrophy into mucinous adenocarcinoma is extremely rare, as the case is the first case to be discovered in Indonesia. Surgery, followed with a strict follow-up regime, is mainstay of treatment in this type of malignancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Adenocarcinoma of mucinous type is a scarce type of bladder exstrophy malignancies. A multidiscipline approach is mandatory in these cases. Strict and regular follow up are suggested for these cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2021.106493","type":"journal-article","created":{"date-parts":[[2021,10,16]],"date-time":"2021-10-16T00:17:40Z","timestamp":1634343460000},"page":"106493","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Adenocarcinoma mucinosum of extrophy bladder"],"prefix":"10.1097","volume":"88","author":[{"given":"Agus Rizal A.H.","family":"Hamid","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaidir Arif","family":"Mochtar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"family":"Lisnawati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meilania","family":"Saraswati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sahat","family":"Matondang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Isa Fuad","family":"Affan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-28-20260114","doi-asserted-by":"crossref","first-page":"555","DOI":"10.4111\/kju.2013.54.8.555","article-title":"Squamous cell carcinoma in exstrophy of the bladder","volume":"54","author":"Sharma","year":"2013","journal-title":"Korean J. Urol"},{"key":"R2-28-20260114","first-page":"D17","article-title":"A rare case of an adult with untreated bladder exstrophy presenting with signet-ring cell adenocarcinoma of urinary bladder","volume":"10","author":"Savalia","year":"2016","journal-title":"J. Clin. Diagn. Res"},{"key":"R4-28-20260114","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1046\/j.1464-4096.2001.2429.x-i7","article-title":"Neoplasia in adult exstrophy patients [5] (multiple letters)","volume":"88","author":"Gearhart","year":"2001","journal-title":"BJU Int"},{"key":"R5-28-20260114","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1016\/S0022-5347(17)67481-0","article-title":"Adenocarcinoma arising in exstrophy of the bladder: report of two cases and review of the literature","volume":"73","author":"McIntosh","year":"1955","journal-title":"J. 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Urol"},{"key":"R8-28-20260114","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.epsc.2017.11.018","article-title":"Rare neuroendocrine tumor decades after bladder exstrophy repair with enterocystoplasty","volume":"31","author":"Roux","year":"2018","journal-title":"J Pediatr Surg Case Rep"},{"key":"R9-28-20260114","doi-asserted-by":"crossref","first-page":"S36","DOI":"10.1186\/1471-2482-13-S2-S36","article-title":"Presenting a case of a mucinous adenocarcinoma of an exstrophic bladder in an adult patient and a review of literature","volume":"13","author":"Di Lauro","year":"2013","journal-title":"BMC Surg"},{"key":"R10-28-20260114","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1097\/00005392-199909010-00021","article-title":"A stage specific approach to tumor surveillance after radical cystectomy for transitional cell carcinoma of the bladder","volume":"162","author":"Slaton","year":"1999","journal-title":"J. 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