This 64-year old patient underwent sigmoid colectomy for moderately-differentiated adenocarcinoma. Seven years later, he developed recurrence in the pelvis and liver metastases. He presented with gross hematuria and was found to have an ulcerated mass in the urinary bladder which was biopsied (shown here). The sections show moderately-differentiated adenocarcinoma consistent with direct extension from rectosigmoid primary.
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