The patient was 39 y/o female with known history of urachal adenocarcinoma of the bladder with metastases to pelvic lymph nodes, peritoneum, bone, and lungs. After initial response to several rounds of chemotherapy she presented with a recurrent tumor in the dome region of her bladder. The tumor has ulcerated to the surface. Note the intact urothelium to the right. The tumor is morphology identical to colorectal adenocarcinomas.