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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.<\/jats:p>","DOI":"10.1136\/bcr-2025-269395","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T18:15:19Z","timestamp":1789150519000},"page":"e269395","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Vesicocutaneous fistula secondary to invasive bladder squamous cell carcinoma: an unusual initial presentation"],"prefix":"10.1136","volume":"19","author":[{"given":"Bilal","family":"Ahmad","sequence":"first","affiliation":[{"name":"Urology, York and Scarborough Teaching Hospitals NHS Foundation Trust, York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Malik","sequence":"additional","affiliation":[{"name":"Urology, York and Scarborough Teaching Hospitals NHS Foundation Trust York Hospital, York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Brown","sequence":"additional","affiliation":[{"name":"Radiology, York and Scarborough Teaching Hospitals NHS Foundation Trust York Hospital, York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish","family":"Kumar","sequence":"additional","affiliation":[{"name":"Urology, York and Scarborough Teaching Hospitals NHS Foundation Trust York Hospital, York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Khafagy","sequence":"additional","affiliation":[{"name":"Urology, York and Scarborough Teaching Hospitals NHS Foundation Trust York Hospital, York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"2026091111150876000_19.9.e269395.1","article-title":"Complex vesicocutaneous fistula: Successful conservative management","volume":"38","author":"Assaker","year":"2021","journal-title":"Urol Case Rep"},{"key":"2026091111150876000_19.9.e269395.2","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1007\/s12262-010-0203-4","article-title":"Vesicocutaneous fistula caused by giant vesical calculus","volume":"73","author":"Deshmukh","year":"2011","journal-title":"Indian J Surg"},{"key":"2026091111150876000_19.9.e269395.3","doi-asserted-by":"publisher","DOI":"10.1006\/gyno.1995.1227"},{"key":"2026091111150876000_19.9.e269395.4","doi-asserted-by":"crossref","first-page":"17562872251317344","DOI":"10.1177\/17562872251317344","article-title":"A comprehensive review of urinary tract fistulas","volume":"17","author":"Nigro","year":"2025","journal-title":"Ther Adv Urol"},{"key":"2026091111150876000_19.9.e269395.5","first-page":"12","article-title":"Conservative management of neovesicocutaneous fistula","volume":"96","author":"Kodama","year":"4568","journal-title":"Case Rep Urol"},{"key":"2026091111150876000_19.9.e269395.6","doi-asserted-by":"crossref","first-page":"131","DOI":"10.30574\/wjarr.2024.22.1.0958","article-title":"Conservative treatment of vesicocutaneous fistula","volume":"22","author":"Rayane","year":"2024","journal-title":"World J Adv Res Rev"},{"key":"2026091111150876000_19.9.e269395.7","doi-asserted-by":"crossref","first-page":"265","DOI":"10.4103\/0019-5359.16302","article-title":"Vesicocutaneous fistula arising from a bladder diverticulum","volume":"59","author":"Kishore","year":"2005","journal-title":"Indian J Med Sci"},{"key":"2026091111150876000_19.9.e269395.8","doi-asserted-by":"crossref","first-page":"17022","DOI":"10.1038\/nrdp.2017.22","article-title":"Bladder cancer","volume":"3","author":"Sanli","year":"2017","journal-title":"Nat Rev Dis Primers"},{"key":"2026091111150876000_19.9.e269395.9","doi-asserted-by":"crossref","first-page":"496","DOI":"10.4111\/kju.2014.55.7.496","article-title":"Vesicoenteric fistula due to bladder squamous cell carcinoma","volume":"55","author":"Kang","year":"2014","journal-title":"Korean J Urol"},{"key":"2026091111150876000_19.9.e269395.10","unstructured":"Zhang Y , Wang J , Liu Z , et al . Histologic variants of bladder cancer. 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