YU-HUI HUANGSUNG-LANG CHEN2026-10-162026-10-162025-04-15Pure ID: 14932690Pure UUID: 9b118bcc-2ca0-458c-9f53-a011ebd065b610.1136/bcr-2025-265360https://www.scopus.com/pages/publications/105003317963https://scholars.csmu.edu.tw/handle/123456789/22362We present a case of a man in his late 70s with a history of peritonitis and vesical stones who developed severe complications after undergoing the transurethral resection of a bladder tumour (TURBT) followed by immediate mitomycin C (MMC) instillation. The patient experienced abdominal pain and haematuria and was subsequently diagnosed with pancytopenia and extraperitoneal bladder rupture. He later developed a urinary tract infection, leading to methicillin-resistant Staphylococcus aureus-related septic pulmonary embolism (SPE). Despite intensive care efforts, his condition deteriorated, culminating in discharge for impending death. Pancytopenia and SPE represent rare but severe complications associated with post-TURBT immediate intravesical MMC instillation. Clinicians must be vigilant for symptoms of bladder perforation and consider deferring to chemotherapy in such cases.enjournal article