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Abdulwahab Almansour H, Bokhari A, AlTamimi AD, Alshammari HA, Abd El Moneim Abdo YH. Partial Cystectomy Management of Bladder Leiomyoma in a Patient With Recurrent Urinary Tract Infections: A Case Study. Cureus 2024; 16:e56419. [PMID: 38638751 PMCID: PMC11026031 DOI: 10.7759/cureus.56419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2024] [Indexed: 04/20/2024] Open
Abstract
Bladder leiomyomas are uncommon benign soft tissue neoplasms of the bladder, frequently observed in women. Diagnosis often happens incidentally during ultrasonography, with symptoms varying based on tumour size and location. Here, we present a case of a 57-year-old woman with poorly controlled type 2 diabetes mellitus, successfully treated for bladder leiomyoma through transurethral resection and laparoscopic partial cystectomy. This case highlights the significance of early detection and timely intervention in optimizing patient outcomes for bladder leiomyoma.
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Affiliation(s)
| | - Akram Bokhari
- Surgery, University of Hail College of Medicine, Hail, SAU
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Singh A, Choudhary A, Pai V, Viswanath K, K R S, Abhishek GV, Chawla A, Hegde P. Uncovering the Uncommon: Institutional Insights Into the Clinical and Epidemiological Characteristics of Rarer Forms of Bladder Cancer Beyond Transitional Cell Carcinoma. Cureus 2023; 15:e40879. [PMID: 37492844 PMCID: PMC10363692 DOI: 10.7759/cureus.40879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2023] [Indexed: 07/27/2023] Open
Abstract
Introduction Non-transitional cell carcinomas of the bladder (NTCCB) represent a significant clinical challenge due to their rarity, heterogeneity, and poor prognosis. Despite their poor prognosis, the treatment of NTCCB has historically been based on the same principles used for transitional cell carcinomas (TCCs). Our study focuses on the management of non-transitional cell carcinomas and aims to identify areas where treatment outcomes can be improved based on our institutional experience. Materials and methods A retrospective analysis of patients with NTCCB who presented at Kasturba Hospital Manipal was conducted between 2012 to 2021. Patient data were collected, and demographic characteristics, presenting symptoms, history of other primary malignancies, comorbidities, location of the tumour, stage at presentation, histopathological subtype, site of systemic metastasis, and primary treatment given were analyzed descriptively. Median overall survival was determined by calculating the time from the initial diagnosis to the date of death. Results Among 31 patients with NTCCB, 15 (48%) presented with metastatic disease, five (16%) with locally advanced disease, and 11 (36%) with localized disease. The most common histopathological subtypes were squamous cell carcinoma and adenocarcinoma, as noted in 14 (45.2%) and 13 (41.9%) patients, respectively, followed by neuroendocrine tumours in two (6.5%), extra-adrenal phaeochromocytoma in one (3.3%), and sarcomatoid carcinoma in one (3.3%) patient, respectively. The lung was the most frequent site of systemic metastasis as noted in six (40%) patients, followed by the liver and skeletal system in three (20%) patients each, peritoneum in two (13.3%), cerebral cortex in one (6.7%), and non-regional lymph nodes in one (6.7%) patient. The primary treatment given included palliative chemotherapy in 14 (45.2%) patients, radical cystectomy with ileal conduit in 10 (32.3%), neoadjuvant chemotherapy only in four (12.9%), partial cystectomy in one (3.2%), pelvic exenteration with ileal conduit in one (3.2%), and peritoneal debulking with palliative chemotherapy in one (3.2%) patient. The overall median survival was 15 months, with a one-year survival rate of 67.4%. Conclusion NTCCB exhibits aggressive clinical behaviour and presents with nonspecific clinical features in the early stages, often leading to late diagnosis and an advanced tumour stage at presentation. Multi-institutional studies with larger patient cohorts are needed to recommend best clinical practices for early detection and optimal treatment strategies to improve patient survival.
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Affiliation(s)
- Anshuman Singh
- Urology, Kasturba Medical College of Manipal, Manipal Academy of Higher Education, Manipal, IND
| | - Anupam Choudhary
- Urology, Kasturba Medical College of Manipal, Manipal Academy of Higher Education, Manipal, IND
| | - Vivek Pai
- Urology, Kasturba Medical College of Manipal, Manipal Academy of Higher Education, Manipal, IND
| | - Kasi Viswanath
- Urology, Kasturba Medical College of Manipal, Manipal Academy of Higher Education, Manipal, IND
| | - Surag K R
- Urology, Kasturba Medical College of Manipal, Manipal Academy of Higher Education, Manipal, IND
| | - Goli V Abhishek
- Urology, Kasturba Medical College of Manipal, Manipal Academy of Higher Education, Manipal, IND
| | - Arun Chawla
- Urology, Kasturba Medical College of Manipal, Manipal Academy of Higher Education, Manipal, IND
| | - Padmaraj Hegde
- Urology, Kasturba Medical College of Manipal, Manipal Academy of Higher Education, Manipal, IND
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Yu EM, Belay S, Li W, Aragon-Ching JB. Non-urothelial and urothelial variants of bladder cancer. Cancer Treat Res Commun 2022; 33:100661. [PMID: 36442362 DOI: 10.1016/j.ctarc.2022.100661] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/14/2022] [Accepted: 11/16/2022] [Indexed: 11/21/2022]
Abstract
Non-urothelial bladder cancers make up a rare minority of all genitourinary (GU) tract histologic cancers since urothelial cancer (UC) makes up the most common histologic subtype. Bladder cancer variant histology (BCVH) or urothelial variants also occur rarely though distinction is important given aggressive presentation and natural history. While methods for diagnosis and treatment of typical urothelial cancers (UC) are well-established, there are no clear guidelines with regard to the diagnosis of non-urothelial bladder cancers, which often results in misdiagnosis and treatment delay. This review will focus on the clinicopathologic characteristics of the most common non-urothelial bladder cancers, to be distinguished from bladder cancer variant histology containing a UC component. The role of genomics in non-urothelial bladder cancers is evolving and the use of biomarkers to guide the diagnosis and treatment of these tumors remains a key area of unmet need. Treatment of these cancers will be discussed in a companion review.
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Affiliation(s)
- Eun-Mi Yu
- GU Medical Oncology, Inova Schar Cancer Institute, USA
| | - Sarah Belay
- University of Virginia School of Medicine, USA
| | - Wenping Li
- Department of Pathology, Inova Fairfax Hospital, USA
| | - Jeanny B Aragon-Ching
- GU Medical Oncology, Inova Schar Cancer Institute, USA; Associate Professor of Medical Education, University of Virginia, USA.
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ŞAHİN M, KURTULUŞ G, ÖZDEMİR Ç, KARALAR M. Comorbidity of "blue" nevi of the uterine cervix and leiomyosarcoma of the bladder: a rare case report. CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1092611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Comorbidity of "blue" nevi of the uterine cervix and leiomyosarcoma of the bladder: a rare case report
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Affiliation(s)
- Merve ŞAHİN
- Afyonkarahisar Sağlık Bilimleri Üniversitesi
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Coiner BL, Cates J, Kamanda S, Giannico GA, Gordetsky JB. Leiomyosarcoma of the urinary bladder: A SEER database study and comparison to leiomyosarcomas of the uterus and extremities/trunk. Ann Diagn Pathol 2021; 53:151743. [PMID: 33964611 DOI: 10.1016/j.anndiagpath.2021.151743] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 04/14/2021] [Indexed: 12/12/2022]
Abstract
No well-established staging system exists for bladder leiomyosarcoma (LMS), and the current staging system does not include tumor size, a thoroughly validated prognostic parameter for sarcomas. Uterine and extremity/trunk LMS are more common than those in the bladder and have well-established staging systems incorporating tumor size. We aim to improve the understanding of LMS of the urinary bladder by assessing cancer-specific survival (CSS) and comparing LMS at this unusual anatomic site to those arising at other sites using the Surveillance, Epidemiology, and End Results (SEER) database. The SEER database (1973-2013) was queried for bladder, uterus, and trunk/extremity LMS. Multivariable Cox proportional hazard regression was performed to identify predictors of CSS for each anatomic location and used to compare outcomes at different sites. We identified 165 bladder, 4987 uterus, and 2536 extremity/trunk LMS cases. Five-year CSS was 52% for uterus, 73% for bladder, and 82% for extremity/trunk LMS. For LMS at all sites, uterine location (HR = 2.14, P < 0.001) and increasing tumor size (HR = 1.05, P < 0.001) were significant predictors of worse CSS on multivariate analysis. For bladder LMS, increasing tumor size (HR = 1.18, P = 0.003) was an independent prognostic factor and the conventional staging cut-off threshold of 5 cm for sarcomas outside the head/neck showed statistical significance in stratifying patient risk of cancer-related death. Bladder LMS appears to have clinical behavior intermediate between those of the extremities/trunk and uterus. We suggest that the conventional sarcoma staging protocols based on tumor size be applied to LMS of the urinary bladder.
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Affiliation(s)
| | - Justin Cates
- Department of Pathology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sonia Kamanda
- Department of Pathology, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Giovanna A Giannico
- Department of Pathology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jennifer B Gordetsky
- Department of Pathology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Urology, Vanderbilt University Medical Center, Nashville, TN, USA.
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Jayarajah U, Fernando MH, Herath KB, de Silva VC, Goonewardena SAS. Partial cystectomy for a primary locally advanced leiomyosarcoma of the bladder: a case report and review of the literature. Clin Case Rep 2018; 6:883-886. [PMID: 29744079 PMCID: PMC5930193 DOI: 10.1002/ccr3.1476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 01/23/2018] [Accepted: 02/10/2018] [Indexed: 11/09/2022] Open
Abstract
Partial cystectomy with wide local excision may be considered a suitable option for selective cases of locally advanced bladder leiomyosarcoma without evidence of distant metastasis; thereby preserving the functional outcome and quality of life. A negative margin, complete tumor resection, and frequent follow-up in such patients are mandatory.
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Affiliation(s)
- Umesh Jayarajah
- Department of Urology National Hospital of Sri Lanka Colombo Sri Lanka
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Menon AR, Puthalath RT, Suresh N, Hegde S. Organ preservation in leiomyosarcoma bladder: Case report and review of literature. Urol Ann 2018; 10:233-236. [PMID: 29719342 PMCID: PMC5907339 DOI: 10.4103/ua.ua_109_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Leiomyosarcomas (LMSs) account for <0.1% of all bladder malignancies. Due to the infrequent occurrence of these tumors, established guidelines for management are lacking. Conventionally, radical extirpative surgery has been advocated. We present our experience with organ preservation in a young male presenting with LMS bladder. A brief review of literature supporting organ preservation in selected cases has also been presented.
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Affiliation(s)
- Arun Ramdas Menon
- Department of Urology, K.S. Hegde Medical Academy, Mangalore, Karnataka, India
| | | | - Nivedita Suresh
- Department of Pathology, K.S. Hegde Medical Academy, Mangalore, Karnataka, India
| | - Suraj Hegde
- Department of Urology, K.S. Hegde Medical Academy, Mangalore, Karnataka, India
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Rodríguez D, Preston MA, Barrisford GW, Olumi AF, Feldman AS. Clinical features of leiomyosarcoma of the urinary bladder: Analysis of 183 cases. Urol Oncol 2014; 32:958-65. [DOI: 10.1016/j.urolonc.2014.01.025] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 01/30/2014] [Accepted: 01/31/2014] [Indexed: 12/31/2022]
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Almadani N, Alsaad KO, Al-Matrafi H, Al Hadab A, Abdullah N, AlKushi A. Urinary bladder radiotherapy-related chondroblastic osteosarcoma: Rare case report and review of literature. Urol Ann 2014; 6:247-50. [PMID: 25125901 PMCID: PMC4127865 DOI: 10.4103/0974-7796.134289] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Accepted: 02/10/2013] [Indexed: 11/04/2022] Open
Abstract
Radiation-related osteosarcomas are well described malignant mesenchymal neoplasms, yet their pathogenesis is not fully understood. They are generally classified into either skeletal osteosarcomas, or their and rare soft tissue counterpart. The occurrence of osteosarcoma in the urinary bladder (UB) following radiotherapy is exceedingly rare. To the best of our knowledge, only two cases of radiation-related urinary bladder osteosarcoma have been published; we herein describe another case of an 85-year-old man who developed post radiotherapy chondroblastic osteosarcoma of the urinary bladder four years following initial surgical resection and radiotherapy for bladder urothelial carcinoma. We believe that this is the first case of radiation-related chondroblastic osteosarcoma arising in the urinary bladder. In addition, we review the literature and explore the possible histogenesis of this rare neoplasm.
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Affiliation(s)
- Noorah Almadani
- Department of Pathology and Laboratory Medicine, King Abdulaziz Medical City and College of Medicine, King Saud University for Health Sciences, Riyadh, Saudi Arabia
| | - Khaled O Alsaad
- Department of Pathology and Laboratory Medicine, King Abdulaziz Medical City and College of Medicine, King Saud University for Health Sciences, Riyadh, Saudi Arabia
| | - Hamoud Al-Matrafi
- Department of Surgery, Section of Urology, King Abdulaziz Medical City and College of Medicine, King Saud University for Health Sciences, Riyadh, Saudi Arabia
| | - Abdulrahman Al Hadab
- Department of Radiation Oncology, King Abdulaziz Medical City and College of Medicine, King Saud University for Health Sciences, Riyadh, Saudi Arabia
| | - Nouf Abdullah
- Department of Diagnostic Imaging, King Abdulaziz Medical City and College of Medicine, King Saud University for Health Sciences, Riyadh, Saudi Arabia
| | - Abdulmohsen AlKushi
- Department of Pathology and Laboratory Medicine, King Abdulaziz Medical City and College of Medicine, King Saud University for Health Sciences, Riyadh, Saudi Arabia
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Urinary Bladder Leiomyosarcoma: Primary Surgical Treatment. Urol Case Rep 2014; 2:137-8. [PMID: 26839792 PMCID: PMC4735486 DOI: 10.1016/j.eucr.2014.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 05/08/2014] [Indexed: 11/23/2022] Open
Abstract
Cases of bladder leiomyosarcoma represent 0.1% of all nonurothelial tumors. We present a case report of a 73-year-old man who underwent a radical cystoprostatectomy for a high-grade bladder leiomyosarcoma with an ileal diversion. The patient recovered uneventfully and no surgical margins were verified in final pathology. Early follow-up at 3 months shows no signs of computed tomography recurrence and adequate adaptation to ileal diversion. Although bladder sarcomas were once thought to have a grim prognosis, recent studies suggest that adequate surgical treatment is able to achieve optimal cancer control outcomes.
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Ravi K, Kumar T, Bakshi H, Desai J, Sen S, Yadav V. Non urothelial bladder cancers: a case series. Indian J Surg Oncol 2014; 4:2-8. [PMID: 24426690 DOI: 10.1007/s13193-012-0176-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2012] [Accepted: 07/23/2012] [Indexed: 11/27/2022] Open
Abstract
Non urothelial bladder cancers frequently present a diagnostic and therapeutic challenge. The article presents a case series of 21 patients of non urothelial urinary bladder cancers presented in our institute over a period of three years and review of literature on this rare condition. Details of patients were reviewed from hospital records of surgical, medical, radiotherapy and pathology departments. Simple percentage and frequencies have been used to interpret the data. Total 21 patients were included in the study. 12 (57.2 %) were males and 9 (42.8 %) were females (M: F :: 4:3). Mean age of the patients was 51.3 years ranging from 22 to 65 years. Eleven (52.3 %) out of twenty one patients had hematuria as their presenting complaint. Out of 21, there were nine (42.8 %) adenocarcinoma, nine (42.8 %) were SCC and one (4.76 %) each of carcinosarcoma, neuroendocrine tumor and sarcoma. Fourteen (66.6 %) patients out of 21 were referred for upfront surgery. Out of remaining seven (33.33 %) patients from the non surgical group three were referred for definitive concurrent chemoradiation, two for definitive radiotherapy. One patient of adenocarcinoma (non urachal) was referred for palliative chemotherapy. Remaining one patient of neuroendocrine tumor who was referred for neoadjuvant chemotherapy died before any definitive treatment could be considered. This study highlights the role of surgery and status of adjuvant therapies in the management of non urothelial bladder cancers.
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Affiliation(s)
- K Ravi
- Surgical Oncology, Gujarat Cancer Research Institute, Ahmedabad, India
| | - Tarun Kumar
- Surgical Oncology, Gujarat Cancer Research Institute, Ahmedabad, India
| | - Hemang Bakshi
- Uro-Oncology, Gujarat Cancer Research Institute, Ahmedabad, India
| | - Janak Desai
- Uro-Oncology, Gujarat Cancer Research Institute, Ahmedabad, India
| | - Sanjay Sen
- Surgical Oncology, Gujarat Cancer Research Institute, Ahmedabad, India
| | - Vijay Yadav
- Surgical Oncology, Gujarat Cancer Research Institute, Ahmedabad, India
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Barry L, Baxter G, Pitchamuthu H, Crooks JE, Rajan P, Ahmad I. Aggressive bladder leiomyosarcoma in a patient receiving tamoxifen therapy. JOURNAL OF CLINICAL UROLOGY 2013. [DOI: 10.1177/2051415813486467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Laura Barry
- Department of Emergency Medicine, Glasgow Royal Infirmary, UK
| | - Grant Baxter
- Department of Radiology, Gartnavel General Hospital, UK
| | | | | | | | - Imran Ahmad
- Urology Group, Beatson Institute for Cancer Research, UK
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Hamadalla NY, Rifat UN, Safi KC, Mohammed M, Abu-Farsakh H. Leiomyosarcoma of the urinary bladder: A review and a report of two further cases. Arab J Urol 2013; 11:159-64. [PMID: 26558075 PMCID: PMC4443010 DOI: 10.1016/j.aju.2013.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 02/25/2013] [Accepted: 03/16/2013] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVES To review the published cases of leiomyosarcoma of the urinary bladder and to report two further cases. METHODS The databases Pubmed and Hinari were searched using the keywords 'bladder', 'leiomyosarcoma' and 'smooth muscle neoplasm'. The 14 articles identified were reviewed, and we present a further two cases. RESULTS Of more than 100 cases reported, 77 were reviewed. There is a lack of consensus about the standard treatment, and little is known about the natural history and prognosis of the tumour, due to its very low incidence. These tumours occur in older adults of either sex and are characterised by an aggressive behaviour. There is usually an unfavourable outcome, with the lungs being the most common site of metastasis. The two further cases we report had a different presentation and outcome. CONCLUSIONS Because of the limited experience with this rare tumour, there are insufficient data to suggest the optimum management strategy and prognosis.
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Xu YF, Wang GC, Zheng JH, Peng B. Partial cystectomy: Is it a reliable option for the treatment of bladder leiomyosarcoma? Can Urol Assoc J 2011; 5:E11-3. [PMID: 21470521 DOI: 10.5489/cuaj.10031] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Bladder leiomyosarcoma is a unique mesenchymal tumour, accounting for less than 0.5% of all primary bladder malignancies. Bladder leiomyosarcoma used to be treated with radical surgery in either old or young patients, often resulting in significant impact on the patients's quality of life after surgery. We report on a case of bladder leiomyosarcoma in a 31-year-old female who was treated with partial cystectomy. Fortunately, no tumour metastasis or relapse was observed during the 7-year follow-up period and the patient now has a good quality of life. We found that partial cystectomy may be an acceptable option to treat bladder leiomyosarcoma in the low MSKCC (Memorial Sloan-Kettering Cancer Center) stage.
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Affiliation(s)
- Yun-Fei Xu
- Department of Urology, Shanghai Tenth People's Hospital of Tongji University, Shanghai, P.R. China
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Lindberg MR, Fisher C, Thway K, Cao D, Cheville JC, Folpe AL. Leiomyosarcoma of the urinary bladder: a clinicopathological study of 34 cases. J Clin Pathol 2010; 63:708-13. [DOI: 10.1136/jcp.2010.077883] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BackgroundLeiomyosarcomas of the urinary bladder (LMS-UB) are rare, usually aggressive neoplasms. Owing to their rarity, only a limited number of cases with clinical follow-up information have been published. There is no current consensus on LMS-UB grading, and it is unknown whether the widely accepted Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC) and National Cancer Institute (NCI) grading systems of soft-tissue sarcomas are applicable to LMS-UB.MethodsThe authors studied 34 well-characterised LMS-UB and compared the prognostic power of the FNCLCC and NCI systems with that of one published grading scheme for LMS-UB (Mayo). All available slides from 34 LMS-UB were retrieved and evaluated with regards to degree of differentiation, mitotic rate/10 high-powered fields (HPF), and % necrosis. Cases were graded using published criteria for the FNCLCC, NCI and Mayo schemes. Follow-up information was obtained.ResultsThe tumours occurred in 17 females and 17 males, ranging from 31 to 91 years (median 65), and measured 2–12 cm in size. One tumour was well differentiated, 17 tumours were moderately differentiated, and 16 tumours were poorly differentiated. Mitotic rates ranged from 1 to >30/10 HPF (median 12/10 HPF), and tumours showed 0–60% necrosis (median 25%). FNCLCC grades were 1 (3), 2 (12) and 3 (19). NCI grades were 1 (2), 2 (11) and 3 (21). Mayo grades were low (7) and high (27). FNCLCC and NCI grades were identical in 23/34 cases (68%). Four cases were FNCLCC/NCI grade 2 or 3 and Mayo low-grade. Clinical follow-up was available for 25 of 34 patients (74%). Clinical follow-up of ≥12 months was available for 17 of these 25 cases (68%) with a median follow-up duration of 52 months (range 12–120 months). Adverse outcome was seen in nine of these 17 patients (53%). Seven of the eight cases (88%) with a clinical follow-up duration of <12 months died of their disease. Overall, adverse outcome was documented in 16 of 25 (64%) cases. Metastatic disease was seen in 13 of 25 (52%) cases, with the lungs being the most common site of metastasis (62%). Adverse outcome was noted in 15 of 23 (65%) of FNCLCC grade 2 or 3 LMS-UB, as compared with zero of two (0%) FNCLCC grade 1 tumours (p=0.15), in 15 of 23 (65%) NCI grade 2 or 3 LMS-UB, versus zero of two (0%) NCI grade 1 sarcomas (p=0.17) and in 13 of 20 (65%) Mayo high grade LMS-UB, as opposed to two of five (40%) low-grade lesions (all results not statistically significant).ConclusionsThe authors conclude that LMS-UB occurs in older adults of either sex and is characterised by aggressive behaviour, with adverse outcome in >60% of cases. Certain advantages of the FNCLCC system may support its more widespread adoption for future studies.
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Nelius T, Stevens J, Samathanam C, Filleur S. Leiomyosarcoma of the urinary bladder presenting as life threatening gross hematuria. Med Oncol 2009; 27:562-7. [DOI: 10.1007/s12032-009-9248-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2009] [Accepted: 05/28/2009] [Indexed: 02/02/2023]
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