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Adamantinoma-like Ewing sarcoma (ALES) is an exceedingly rare neoplasm, typically arising in the head and neck. We present a case of bladder tumour initially diagnosed as urothelial carcinoma on transurethral resection, which after neoadjuvant dose-dense methotrexate, vinblastine, doxorubicin and cisplatin and subsequent radical cystoprostatectomy was reclassified as ALES with no residual urothelial carcinoma.