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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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2
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Bahadur A, Mundhra R, Ravi AK, Gill P, Pathak A, Suresh G, Singhvi S, Mallick B, Singh A, Rao S. Ureteric Leiomyosarcoma. Cureus 2023; 15:e49758. [PMID: 38161829 PMCID: PMC10757693 DOI: 10.7759/cureus.49758] [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: 11/30/2023] [Indexed: 01/03/2024] Open
Abstract
Ureteric leiomyosarcoma is a rare but aggressive tumor among other sarcomas. There is no established epidemiological data due to the scarcity of literature on this uncommon disorder. The present literature comprises about 20 case reports mostly of women above 40 years of age. The presenting complaint is mostly pain in the abdomen with only a few reporting urological symptoms like hematuria. Understandably, this tumor is diagnosed by histopathological examination with immunohistochemistry. We report one such case of a 32-year-old female who underwent an exploratory laparotomy with preoperative suspicion of adnexal neoplastic mass only to find normal ovaries and left ureteric tumor intraoperatively. She was managed with excision of the tumor with partial resection of the involved ureter and end-to-end anastomosis of the ureter followed by chemotherapy and radiation.
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Affiliation(s)
- Anupama Bahadur
- Obstetrics and Gynecology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Rajlaxmi Mundhra
- Obstetrics and Gynecology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Anoosha K Ravi
- Obstetrics and Gynecology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Poonam Gill
- Obstetrics and Gynecology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Anjali Pathak
- Obstetrics and Gynecology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Gayatri Suresh
- Obstetrics and Gynecology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Shreya Singhvi
- Obstetrics and Gynecology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Bhawana Mallick
- Obstetrics and Gynecology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Ashok Singh
- Pathology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Shalinee Rao
- Pathology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
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3
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Cui J, Peng R, Zhang Y, Lu Y, He X, Chen M, Zhang H. Case Report: Primary low-grade dedifferentiated liposarcoma of the urinary bladder with molecular confirmation. Front Oncol 2023; 13:1221027. [PMID: 37881487 PMCID: PMC10597670 DOI: 10.3389/fonc.2023.1221027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 09/18/2023] [Indexed: 10/27/2023] Open
Abstract
Liposarcomas originating in the urinary bladder are extremely rare. Only six cases of bladder liposarcoma have been reported, and all have been described as myxoid liposarcomas. Notably, none of the patients underwent molecular testing. Here, we report a dedifferentiated liposarcoma (DDL) that occurred in the urinary bladder, primarily in a 69-year-old Chinese woman, with infrequent low-grade dedifferentiation. Computed tomography (CT) revealed an ill-defined solid mass in the anterior bladder wall. The patient underwent a partial bladder resection. Histologically, the tumor cells with mild-to-moderate nuclear atypia were arranged in fascicular and storiform patterns, mimicking a low-grade fibroblastic tumor. In addition, scattered small foci of typical lipoma-like well-differentiated components were identified. Immunohistochemically, the tumor tested positivity for MDM2, CDK4, and p16. Fluorescence in situ hybridization revealed MDM2 gene amplification in the neoplastic cells. Whole-exome sequencing showed that this tumor also harbored CDK4, TSPAN31, and JUN amplification. At the latest follow-up (85 months after surgery), the patient was alive, with no evidence of disease. To the best of our knowledge, this is the first example of a molecularly confirmed primary bladder liposarcoma and the first case of DDL at this site.
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Affiliation(s)
| | | | | | | | | | | | - Hongying Zhang
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
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4
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Trigui M, Ouanes Y, Chaker K, Marrak M, Bellil K, Nouira Y. A round cell sarcoma of the bladder following radiotherapy: A case Report. Urol Case Rep 2023; 48:102402. [PMID: 37123511 PMCID: PMC10131035 DOI: 10.1016/j.eucr.2023.102402] [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: 02/19/2023] [Revised: 04/05/2023] [Accepted: 04/12/2023] [Indexed: 05/02/2023] Open
Abstract
Sarcomas are uncommon and extremely aggressive malignancies. Sarcomas of the bladder are exceedingly rare. We report the case of 67-year-old female patient having had 20 years ago a total hysterectomy with bilateral adnexectomy followed by adjuvant external radiotherapy to an undifferentiated uterine sarcoma, was presented with hematuria. An abdomino-pelvic Computed Tomography (CT) Scan was done showing a 5 cm budding lesion of the bladder floor. An anterior pelvectomy with external urinary diversion was undergone. The histological examination showed a high grade urothelial carcinoma infiltrating the muscle with a sarcomatoid component.
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Affiliation(s)
- Mohamed Trigui
- Department of Urology, LA RABTA Hospital, University of TUNIS EL MANAR, Tunis, Tunisia
- Corresponding author. La RABTA hospital, Department of Urology, BAB SAADOUN, 1006, Tunis, Tunisia.
| | - Yassine Ouanes
- Department of Urology, LA RABTA Hospital, University of TUNIS EL MANAR, Tunis, Tunisia
| | - Kays Chaker
- Department of Urology, LA RABTA Hospital, University of TUNIS EL MANAR, Tunis, Tunisia
| | - Mahdi Marrak
- Department of Urology, LA RABTA Hospital, University of TUNIS EL MANAR, Tunis, Tunisia
| | - Khadija Bellil
- Department of Pathology, LA RABTA Hospital, University of TUNIS EL MANAR, Tunis, Tunisia
| | - Yassine Nouira
- Department of Urology, LA RABTA Hospital, University of TUNIS EL MANAR, Tunis, Tunisia
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5
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Brocklehurst A, Varughese M, Birtle A. Bladder Preservation for Muscle-Invasive Bladder Cancer With Variant Histology. Semin Radiat Oncol 2023; 33:62-69. [PMID: 36517195 DOI: 10.1016/j.semradonc.2022.10.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
A growing body of evidence has shown bladder-preservation with chemo-radiotherapy achieves comparable survival to Radical Cystectomy (5-year OS 50%-70%) and superior quality of life outcomes for patients with muscle-invasive urothelial carcinoma of the bladder (UC). However, up to 55% of patients harbor variant histology and in this review we aim to clarify the role of bladder-preservation for this group. We first draw the distinction between urothelial carcinoma with divergent differentiation (UCDD) and non-urothelial carcinoma (NUC). UCDD is common, increasing in prevalence, and whilst each subtype may have its own characteristics current evidence suggests comparable outcomes with radical cystectomy and bladder-preservation. Non-urothelial carcinoma is a collection of distinct pathologies each deserving of its own management strategy. However, these tumors are rare, and evidence is generated from retrospective studies with significant inherent bias. Small cell carcinoma of the bladder has good evidence for bladder-preservation; however, other pathologies such as Squamous Cell Carcinoma and Adenocarcinoma are not well supported. We recommend careful multidisciplinary appraisal of the evidence for each subtype and honest patient discussion about the limited evidence before reaching management decisions. As we look to the future molecular-profiling may help better characterize these tumors and aid in treatment selection.
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Affiliation(s)
| | - Mohini Varughese
- Royal Devon & Exeter NHS Foundation Trust, University of Exeter, United Kingdom
| | - Alison Birtle
- Rosemere Cancer Centre, Preston, Lancs; University of Manchester; University of Central Lancashire
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6
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Vias P, Goyal S, Periasamy K, Madan R, Devana SK, Bal A, Kundu R. Leiomyosarcoma of urinary bladder with unusual recurrence in intestinal mucosa and peritoneum: a case report. J Egypt Natl Canc Inst 2021; 33:38. [PMID: 34897558 DOI: 10.1186/s43046-021-00095-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 11/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Leiomyosarcomas of urinary bladder constitute rare malignant sarcomas with very few cases reported in literature. CASE PRESENTATION Here, we present a case of bladder leiomyosarcoma in a well-preserved female. She failed to respond to standard chemotherapy and had a rapidly downhill course with unusual metastases in anastomotic site and peritoneum soon after surgery. Despite multimodality management including resection of primary and metastatic site, systemic therapy and pelvic radiotherapy, our patient had dismal prognosis with an overall survival of 1.7 years. CONCLUSION Leiomyosarcomas of bladder are aggressive tumors and have a very poor prognosis; thus, future research should focus on optimizing more effective treatment regimes.
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Affiliation(s)
- Poorva Vias
- Department of Radiotherapy, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Shikha Goyal
- Department of Radiotherapy, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
| | - Kannan Periasamy
- Department of Radiotherapy, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Renu Madan
- Department of Radiotherapy, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Sudheer Kumar Devana
- Department of Urology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Amanjit Bal
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Reetu Kundu
- Department of Cytology and Gynaecological Pathology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
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7
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Ishizaki A, Okuwaki K, Kida M, Imaizumi H, Iwai T, Yamauchi H, Kaneko T, Hasegawa R, Masutani H, Tadehara M, Adachi K, Watanabe M, Kurosu T, Tamaki A, Koizumi W. The First Case of Metastatic Pancreatic Leiomyosarcoma Derived from the Urinary Bladder Diagnosed Using an Endoscopic Ultrasound-guided Fine-needle Biopsy. Intern Med 2021; 60:1377-1381. [PMID: 33250467 PMCID: PMC8170231 DOI: 10.2169/internalmedicine.6143-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
We herein report the first case of metastatic pancreatic leiomyosarcoma derived from the urinary bladder diagnosed by an endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) in a 65-year-old woman. The patient had undergone total cystectomy for bladder leiomyosarcoma. Four years thereafter, a nodule was observed in her left lung on chest computed tomography. Suspecting primary lung cancer, pulmonologists at our hospital recommended a thoracoscopic lung biopsy, which the patient refused. Five years post-cystectomy, fluorodeoxyglucose positron emission tomography revealed enlargement of the left lung nodule and a new mass in the pancreatic head. She was referred to our department for the pathological diagnosis of a pancreatic head mass by an EUS-FNB. The EUS-FNB yielded adequate pancreatic tissue for an immunohistochemical analysis. A diagnosis of metastatic pancreatic lesion originating from the urinary bladder was made. In atypical pancreatic tumors, the utilization of an EUS-FNB and immunohistochemical analysis can help establish an accurate diagnosis.
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Affiliation(s)
- Ayana Ishizaki
- Department of Gastroenterology, Kitasato University School of Medicine, Japan
| | - Kosuke Okuwaki
- Department of Gastroenterology, Kitasato University School of Medicine, Japan
| | - Mitsuhiro Kida
- Department of Gastroenterology, Kitasato University School of Medicine, Japan
| | - Hiroshi Imaizumi
- Department of Gastroenterology, Kitasato University School of Medicine, Japan
| | - Tomohisa Iwai
- Department of Gastroenterology, Kitasato University School of Medicine, Japan
| | - Hiroshi Yamauchi
- Department of Gastroenterology, Kitasato University School of Medicine, Japan
| | - Toru Kaneko
- Department of Gastroenterology, Kitasato University School of Medicine, Japan
| | - Rikiya Hasegawa
- Department of Gastroenterology, Kitasato University School of Medicine, Japan
| | - Hironori Masutani
- Department of Gastroenterology, Kitasato University School of Medicine, Japan
| | - Masayoshi Tadehara
- Department of Gastroenterology, Kitasato University School of Medicine, Japan
| | - Kai Adachi
- Department of Gastroenterology, Kitasato University School of Medicine, Japan
| | - Masafumi Watanabe
- Department of Gastroenterology, Kitasato University School of Medicine, Japan
| | - Takahiro Kurosu
- Department of Gastroenterology, Kitasato University School of Medicine, Japan
| | - Akihiro Tamaki
- Department of Gastroenterology, Kitasato University School of Medicine, Japan
| | - Wasaburo Koizumi
- Department of Gastroenterology, Kitasato University School of Medicine, Japan
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8
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Li L, Liang J, Song T, Yin S, Zeng J, Zhong Q, Feng X, Jia Z, Fan Y, Wang X, Lin T. A Nomogram Model to Predict Prognosis of Patients With Genitourinary Sarcoma. Front Oncol 2021; 11:656325. [PMID: 33937065 PMCID: PMC8085422 DOI: 10.3389/fonc.2021.656325] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 03/22/2021] [Indexed: 02/05/2023] Open
Abstract
Objectives The aim of this study is to evaluate the significant factors influencing the overall survival (OS) and recurrence free survival (RFS) and make an attempt to develop a nomogram for predicting the prognosis of patients with genitourinary sarcoma (GS). Methods Data on adult GS from 1985 to 2010 were collected. The impact of clinical factors on OS and RFS were estimated by Kaplan–Meier (KM) analysis, and differences between groups were analyzed by the log-rank test. To establish a nomogram, all patients were randomly divided into a training set (n = 125) and a testing set (n = 63). Cox proportion hazard model was utilized to assess the prognostic effect of variables. Then, a nomogram was established to estimate 1-, 3-, and 5-year OS based on Cox regression model. Subsequently, the nomogram was validated by a training set and a validation set. Results A total of 188 patients were enrolled into our study. Male patients with bladder sarcoma had better OS rather than RFS when stratified by gender (P = 0.022). According to histological subtypes, patients with leiomyosarcoma (LMS) undergoing chemotherapy were associated with favorable OS (P = 0.024) and RFS (P = 0.001). Furthermore, LMS in kidney sarcoma were associated with lower recurrence rate in comparison to rhabdomyosarcoma (RMS) (P = 0.043). Margin status after surgical excision markedly influenced the OS and RFS of GS patients and negative margins presented optimal prognosis. Chemotherapy was associated with improved OS for patients without surgery (P = 0.029) and patients with positive margins (P = 0.026). Based on the multivariate analysis of the training cohort, age, gender, surgery status, histological subtype, and chemotherapy were included in our nomogram for prediction of OS. The nomogram had sufficient power with concordance index (C-index) of OS: 0.770, 95%CI: 0.760–0.772 and area under curve (AUC) of OS: 0.759, 95%CI: 0.658–0.859 in the training set and with C-index of OS: 0.741, 95%CI: 0.740–0.765, and AUC of OS: 0.744, 95%CI: 0.576–0.913 in the validation set. Conclusions Adults GS is a group of extremely rare tumors with poor prognosis. Of all histological types, LMS is sensitive to chemotherapy. We highlighted the cardinal role of surgical resection and the importance of achieving negative margins. We identified the efficacy of chemotherapy for patients with positive margins and those without surgery as well. A nomogram is validated as an effective tool predicting short-term outcomes.
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Affiliation(s)
- Linde Li
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China.,Organ Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jiayu Liang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China.,Organ Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Turun Song
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China.,Organ Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Saifu Yin
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China.,Organ Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jun Zeng
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China.,Organ Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Qiang Zhong
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China.,Organ Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaobing Feng
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China.,Organ Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Zihao Jia
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China.,Organ Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yu Fan
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China.,Organ Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xianding Wang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China.,Organ Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Tao Lin
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China.,Organ Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
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9
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Angiosarcoma of the Urinary Bladder Following Radiotherapy: Report of a Case and Review of the Literature. ACTA ACUST UNITED AC 2021; 57:medicina57040329. [PMID: 33915778 PMCID: PMC8066026 DOI: 10.3390/medicina57040329] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/25/2021] [Accepted: 03/27/2021] [Indexed: 11/16/2022]
Abstract
Background and objectives: Angiosarcomas are uncommon and extremely aggressive malignancies derived from vascular endothelial cells. Although they can occur anywhere in the body and at any age, they are more frequently found in the skin of the head and neck regions and in the elderly. Few cases have been recorded in deep soft tissues and in parenchymal organs. Angiosarcomas of the urinary bladder are exceedingly rare. They usually arise in adult patients with a history of radiation therapy, cigarette smoking, or exposure to chemical agents (e.g., vinyl chloride). Despite multidisciplinary treatment approaches combining surgery, radiotherapy, and chemotherapy, prognosis is dismal. Materials and Methods: We describe a case of a 78-year-old Caucasian man presenting with a vesical mass incidentally discovered with abdominal computerized tomography (CT). He underwent transurethral resection of the bladder (TURB), and histology was compatible with angiosarcoma. Results: The patient had been a heavy smoker and his medical history included therapeutic irradiation for prostate cancer eight years previously. Radical cystoprostatectomy was feasible, and pathologic examination of the surgical specimen confirmed angiosarcoma involving the urinary bladder, prostate, and seminal vesicles. Post-operative peritonitis resulted in progressive multi-organ failure and death. Conclusions: Angiosarcoma primary to the urinary bladder is seldom encountered, however, it should be considered in the differential diagnosis of vesical tumors, especially in elderly men with a history of pelvic radiotherapy.
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10
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Surgical Management of Large Liver Metastases from Urinary Bladder Leiomyosarcoma. ARS MEDICA TOMITANA 2021. [DOI: 10.2478/arsm-2021-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Leiomyosarcoma is a malignant tumor developed from the smooth muscle. It can arise in different sites especiallyin gastrointestinal tract (stomach, small bowel and colon), genitourinary tract (uterus, bladder and kidney) and the retroperitoneum (inferior vena cava) (1,2). It’s localization in the bladder is rare, representing 0.5% of all urinary bladder malignancies. There are over 210 cases reported in literature(3).Ten to 30% of the patients willpossibly develop metastases and the most common sites are lungs, liver and bone(4,5). There is no concensus on a standard treatment due to its very low incidence.
We report here a rare case of a surgical management of large liver metastases from urinary bladder leiomyosarcoma.
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11
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Urasaki T, Nakano K, Tomomatsu J, Komai Y, Yuasa T, Yamashita K, Takazawa Y, Yamamoto S, Yonese J, Takahashi S. Adult genitourinary sarcoma: The era of optional chemotherapeutic agents for soft tissue sarcoma. Int J Urol 2020; 28:91-97. [PMID: 33169456 DOI: 10.1111/iju.14417] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 09/27/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To report our institutional experience with treatment of primary genitourinary soft tissue sarcoma. METHODS We retrospectively reviewed the medical records of adult soft tissue sarcoma patients treated between March 2005 and May 2019. The primary tumor sites included the prostate, kidney, urinary bladder and the paratesticular structures. RESULTS A total of 19 patients - 16 men (84%) and three women (16%) - were enrolled in the study. The median age was 41 years (range 20-79 years). The most common primary site was the prostate (in eight patients; 42%), and prostatic sarcoma patients were younger than patients with sarcomas of other origins. The most common histological subtype was leiomyosarcoma (in five patients; 26%). The overall survival rates after 1, 3 and 5 years were 61.5%, 34.4% and 25.8%, respectively. The median survival time was 20.7 months (95% confidence interval 5.9-35.5 months). Univariate analysis showed that an absence of metastasis at diagnosis and complete surgical resection were predictive of favorable survival. In the chemotherapy group, the objective response rate was 20.5%. Pazopanib was administered to nine patients in the late-line setting, and the objective response rate was 11.1%; six grade ≥3 adverse events were observed in three patients. CONCLUSIONS Inoperable metastatic genitourinary soft tissue sarcoma remains difficult to treat, as previously reported. Further investigation on this malignancy, including optimization of currently available antitumor drugs and the development of novel therapeutic agents, is required.
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Affiliation(s)
- Tetsuya Urasaki
- Departments of, Department of, Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kenji Nakano
- Departments of, Department of, Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Junichi Tomomatsu
- Departments of, Department of, Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yoshinobu Komai
- Department of, Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Takeshi Yuasa
- Department of, Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kyoko Yamashita
- Department of, Pathology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yutaka Takazawa
- Department of, Pathology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shinya Yamamoto
- Department of, Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Junji Yonese
- Department of, Urology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shunji Takahashi
- Departments of, Department of, Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
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12
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Fiorentino V, Pierconti F, Lenci N, Calicchia M, Palermo G, Bassi P, Larocca LM, Martini M. Urinary bladder leiomyosarcoma with osteoclast-like multinucleated giant cells: a case report. BMC Cancer 2019; 19:763. [PMID: 31375071 PMCID: PMC6679448 DOI: 10.1186/s12885-019-5981-x] [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: 03/16/2019] [Accepted: 07/26/2019] [Indexed: 11/25/2022] Open
Abstract
Background Bladder leiomyosarcoma is the most frequent mesenchymal neoplasm of the bladder. However, the rarity of the disease and some morphological aspects could give serious problems to differential diagnosis. Case presentation A 86-year-old male patient was referred to our institution to undergo endoscopic low-urinary-tract re-evaluation 2 months after the detection of a “low-grade urothelial neoplasia” in urinary cytology. A TURBT (transurethral resection of bladder tumor) was performed and revealed a tumor extending for 3.5 cm with thin stalk peduncle on the left lateral wall of the bladder, cephalad and lateral to the left ureteral orifice. The exophytic part of the tumor was resected with the underlying bladder wall. Histologically, the tumor showed a quite complex pattern, composed of spindle cells, with often invasion to the surrounding bladder muscular wall, and the presence of numerous multinucleated, osteoclast-like giant cells, scattered throughout the neoplasia. Conclusions Here we report a unique case of urinary bladder leiomyosarcoma with osteoclast-like multinucleated giant cells (OGCs). These cells, confounding the morphological aspect, indeed showed an immunohistochemical phenotype of non-neoplastic origin (most likely a histiocyte/macrophage differentiation). We feel that the presence of the OGCs within this tumor is reactive. Nevertheless, more research is necessary to understand the role of OGCs in urinary bladder tumors and leiomyosarcoma, in paticular.
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Affiliation(s)
- Vincenzo Fiorentino
- Servizio di Istopatologia e Citodiagnosi, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy.,Institute of Pathology, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Francesco Pierconti
- Servizio di Istopatologia e Citodiagnosi, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy.,Institute of Pathology, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Niccolò Lenci
- Clinica Urologica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Martina Calicchia
- Servizio di Istopatologia e Citodiagnosi, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy.,Institute of Pathology, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Giuseppe Palermo
- Clinica Urologica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Pierfrancesco Bassi
- Institute of Urology, Università Cattolica del Sacro Cuore, Roma, Italy.,Clinica Urologica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Luigi Maria Larocca
- Servizio di Istopatologia e Citodiagnosi, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy.,Institute of Pathology, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Maurizio Martini
- Servizio di Istopatologia e Citodiagnosi, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy. .,Institute of Pathology, Università Cattolica del Sacro Cuore, Roma, Italy.
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13
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Molecular and histopathology directed therapy for advanced bladder cancer. Nat Rev Urol 2019; 16:465-483. [PMID: 31289379 DOI: 10.1038/s41585-019-0208-0] [Citation(s) in RCA: 91] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2019] [Indexed: 12/29/2022]
Abstract
Bladder cancer is a heterogeneous group of tumours with at least 40 histological subgroups. Patients with localized disease can be cured with surgical resection or radiotherapy, but such curative options are limited in the setting of recurrent disease or distant spread, in which case systemic therapy is used to control disease and palliate symptoms. Cytotoxic chemotherapy has been the mainstay of treatment for advanced bladder cancer, but high-quality evidence is lacking to inform the management of rare subgroups that are often excluded from studies. Advances in molecular pathology, the development of targeted therapies and the resurgence of immunotherapy have led to the reclassification of bladder cancer subgroups and rigorous efforts to define predictive biomarkers for cancer therapies. In this Review, we present the current evidence for the management of conventional, variant and divergent urothelial cancer subtypes, as well as non-urothelial bladder cancers, and discuss how the integration of genomic, transcriptomic and proteomic characterization of bladder cancer could guide future therapies.
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14
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Sabaté Arroyo X, Rodrigo Lara H, Carrillo García P, Brugarolas Rosselló J, Pizá Reus P. Sarcomatoid urothelial bladder carcinoma in adults: Histology, symptomatology, treatments and survival. Actas Urol Esp 2019; 43:106-110. [PMID: 30287139 DOI: 10.1016/j.acuro.2018.05.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 05/07/2018] [Accepted: 05/08/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Sarcomatoid urothelial bladder carcinoma comprises 3% of the tumours of the bladder and is considered one of the most aggressive tumours of the urinary tract. Our aim is to analyse the characteristics of sarcomatoid urothelial bladder carcinoma in adults, its treatments and survival. METHOD A retrospective study performed between 2000 and 2017 of all the patients with a sarcomatoid urothelial bladder carcinoma in a single centre. We studied the anatomopathological characteristics, symptoms at time of diagnosis, treatment given and survival according to the treatment given. RESULTS Sixteen patients were diagnosed with sarcomatoid carcinoma, 11 with no heterologous component, one with rhabdomyosarcomatous components, 2 with chondrosarcomatous components and 2 with osteosarcomatous components. The mean age was 74 years (±20) and 88% were smokers. The primary symptom was haematuria, and the least well-tolerated was dysuria together with hypogastric pain. Ninety-four percent of the patients had muscle layer infiltration and 18% had metastases at the time of diagnosis. Thirty-seven percent of the patients were treated by radical cystectomy, thirteen percent by radical cystectomy plus adjuvant chemotherapy, and 50% were treated by palliative transurethral resection to control their symptoms. A survival curve was made with the different treatments given, which showed a mean global survival of 7 months and no statistically significant differences in terms of survival according to the treatment given. CONCLUSIONS Sarcomatoid urothelial carcinoma is an aggressive disease, of rapid and torpid onset which occurs in patients of advanced age and smokers. There are no established treatment guidelines, and it appears that no treatment influences increased survival. Cystectomy should be evaluated as a treatment alternative for patients whose symptoms are difficult to control. The various heterologous components do not appear to influence the progression of the disease or patient survival.
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15
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Nizam A, Paquette EL, Wang BG, Aragon-Ching JB. Epithelioid Angiosarcoma of the Bladder: A Case Report and Review of the Literature. Clin Genitourin Cancer 2018; 16:e1091-e1095. [PMID: 30143439 DOI: 10.1016/j.clgc.2018.07.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 07/14/2018] [Indexed: 11/18/2022]
Affiliation(s)
- Amanda Nizam
- Department of Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | | | - Brant G Wang
- Department of Pathology, Inova Fairfax Hospital, Fairfax, VA
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16
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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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17
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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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18
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Vetterlein MW, Wankowicz SAM, Seisen T, Lander R, Löppenberg B, Chun FKH, Menon M, Sun M, Barletta JA, Choueiri TK, Bellmunt J, Trinh QD, Preston MA. Neoadjuvant chemotherapy prior to radical cystectomy for muscle-invasive bladder cancer with variant histology. Cancer 2017; 123:4346-4355. [DOI: 10.1002/cncr.30907] [Citation(s) in RCA: 109] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 06/30/2017] [Accepted: 07/05/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Malte W. Vetterlein
- Division of Urological Surgery; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School; Boston Massachusetts
- Department of Urology; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - Stephanie A. M. Wankowicz
- Lank Center for Genitourinary Oncology; Dana-Farber Cancer Institute, Harvard Medical School; Boston Massachusetts
| | - Thomas Seisen
- Division of Urological Surgery; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School; Boston Massachusetts
- Department of Urology; Pitié-Salpêtriére Hospital, Pierre and Marie Curie University; Paris France
| | - Richard Lander
- Division of Urological Surgery; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School; Boston Massachusetts
| | - Björn Löppenberg
- Division of Urological Surgery; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School; Boston Massachusetts
- Department of Urology; Marien Hospital Herne, Ruhr-University Bochum; Herne Germany
| | - Felix K.-H. Chun
- Department of Urology; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - Mani Menon
- Center for Outcomes Research; Analytics and Evaluation, Vattikuti Urology Institute, Henry Ford Health System; Detroit Michigan
| | - Maxine Sun
- Division of Urological Surgery; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School; Boston Massachusetts
| | - Justine A. Barletta
- Department of Pathology; Brigham and Women's Hospital, Harvard Medical School; Boston Massachusetts
| | - Toni K. Choueiri
- Lank Center for Genitourinary Oncology; Dana-Farber Cancer Institute, Harvard Medical School; Boston Massachusetts
| | - Joaquim Bellmunt
- Lank Center for Genitourinary Oncology; Dana-Farber Cancer Institute, Harvard Medical School; Boston Massachusetts
| | - Quoc-Dien Trinh
- Division of Urological Surgery; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School; Boston Massachusetts
| | - Mark A. Preston
- Division of Urological Surgery; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School; Boston Massachusetts
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19
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Nawar NA, Olsen J, Jelic TM, He C. Primary Urinary Bladder Angiosarcoma with Osteoclast-Like Multinucleated Giant Cells: A Case Report and Literature Review. AMERICAN JOURNAL OF CASE REPORTS 2016; 17:143-9. [PMID: 26947436 PMCID: PMC4784551 DOI: 10.12659/ajcr.896266] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Patient: Male, 68 Final Diagnosis: Urinary bladder angiosarcoma Symptoms: — Medication: — Clinical Procedure: TURBT Specialty: Diagnostics, Laboratory
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Affiliation(s)
- Nariman A Nawar
- Department of Pathology, West Virginia University, Morgantown, WV, USA
| | - Jamie Olsen
- Department of Urology, Charleston Area Medical Center, Charleston, WV, USA
| | - Tomislav M Jelic
- Department of Pathology, Charleston Area Medical Center, Charleston, WV, USA
| | - Chun He
- Department of Pathology, Charleston Area Medical Center, Charleston, WV, USA
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20
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Abstract
BACKGROUND Rhabdomyosarcoma is the most common sarcoma of soft tissues in childhood and adolescence, with an annual incidence of 4-7 cases per million children aged 15. Embryonal rhabdomyosarcoma is common in adults younger than 30 years, and are usually presented as a large painless, palpable mass (> 5cm). Survival in the case of paratesticular sarcoma in men is approximately 50%. CLINICAL CASE Male 27 years of age with no history of importance, was seen in a clinic with an increased, painless, left testicular volume 3 years onset. Intrascrotal left testicle increased volume, with dimensions of 20×12×8cm, a stone and left inguinal node in induratum measuring 2×2cm. Microscopically, it showed a pattern of an embryonal rhabdomyosarcoma with left inguinal node metastases. CONCLUSION Early diagnosis of testicular tumours, and especially of primary intratesticular rhabdomyosarcomas, and aggressive surgical treatment in combination with chemotherapy reduces the incidence of local recurrence and may improve the rate of disease-free survival and overall survival in adult patients with metastases.
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21
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Yi J, Zhou DA, Huo JR, Wang YH, Ma JA. Primary intratesticular rhabdomyosarcoma: A case report and literature review. Oncol Lett 2015; 11:1016-1020. [PMID: 26893684 DOI: 10.3892/ol.2015.3987] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 11/05/2015] [Indexed: 11/06/2022] Open
Abstract
Rhabdomyosarcoma (RMS) that primarily occurs in the testes is particularly rare, with only retrospective studies and sporadic cases reported in the literature. The present study describes the case of a large, primary intratesticular RMS (ITRMS) that was treated with a radical inguinal orchiectomy (RIO) and a regimen of chemotherapy. The study also presents a review of the literature regarding primary ITRMSs, aiming to elucidate the clinical characteristics and optimal treatment of the disease. A 14-year-old male presented with a 1-year history of a slow-growing, painless, left scrotal mass. Magnetic resonance imaging identified a mass in the left scrotum with mixed signal intensity; no abnormal signals were identified in the right testicle and retroperitoneal lymph node. An X-ray of the chest demonstrated no evidence of metastasis. Subsequent to this, a left RIO was performed. Histopathological and immunohistochemical examination confirmed the final diagnosis of embryonal ITRMS. At 21 days post-surgery, an 18F-fluorodeoxyglucose-positron emission tomography-computed tomography (FDG-PET-CT) scan identified widespread metastatic lesions in the lungs, local lymph nodes and bones, presenting as increased glucose metabolism nodules. Subsequently, the patient received six sequential cycles of adjunct chemotherapy. The patient is alive with disease in October 2015. The case described is noteworthy as it is an example of ITRMS, in which the patient received successful treatment. However, multidisciplinary treatment may further improve the outcome of the disease.
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Affiliation(s)
- Jun Yi
- Department of Gastroenterology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, P.R. China
| | - Dong-Ai Zhou
- Department of Oncology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, P.R. China
| | - Ji-Rong Huo
- Department of Gastroenterology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, P.R. China
| | - Yun-Hua Wang
- Positron Emission Tomography-Computed Tomography Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, P.R. China
| | - Jin-An Ma
- Department of Oncology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, P.R. China
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22
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Unal OU, Oztop I, Menekse S, Urakci Z, Bozkurt O, Ozcelik M, Gunaydin Y, Yasar N, Yazilitas D, Kodaz H, Taskoylu BY, Aksoy A, Demirci U, Araz M, Tonyali O, Sevinc A, Yilmaz AU, Benekli M. Adult Urological Soft Tissue Sarcomas: A Multicenter Study of the Anatolian Society of Medical Oncology (ASMO). Asian Pac J Cancer Prev 2015; 16:4777-80. [PMID: 26107239 DOI: 10.7314/apjcp.2015.16.11.4777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To analyze clinicopathological characteristics, prognostic factors and survival rates of the patients with urological soft tissue sarcomas treated and followed up in Turkey. MATERIALS AND METHODS For overall survival analyses the Kaplan-Meier method was used. From medical records, nine prognostic factors on overall survival were analysed. RESULTS For the 53 patients (34 males, 19 females) whose charts were reviewed, the median age was 53 (range 22 to 83) years. Most frequently renal location (n=30; 56.6%) was evident and leiomyosarcoma (n=20, 37.7%) was the most frequently encountered histological type. Median survival time of all patients was 40.3 (95% CI, 14.2-66.3) months. In univariate analysis, male gender, advanced age (≥50 years), metastatic stage, unresectability, grade 3, renal location were determined as worse prognostic factors. In multivariate analysis, metastatic stage, unresectability and grade 3 were determined as indicators of worse prognosis. CONCLUSIONS Urological soft tissue sarcomas are rarely seen tumours in adults. The most important factors in survival are surgical resection, stage of the tumour at onset, grade and location of the tumour, gender and age of the patients.
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Affiliation(s)
- Olcun Umit Unal
- Division of Medical Oncology, Department of Internal Medicine, Dokuz Eylul University Medical Faculty, Izmir, Turkey E-mail :
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23
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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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24
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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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25
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Zhong M, Gersbach E, Rohan SM, Yang XJ. Primary adenocarcinoma of the urinary bladder: differential diagnosis and clinical relevance. Arch Pathol Lab Med 2013; 137:371-81. [PMID: 23451748 DOI: 10.5858/arpa.2012-0076-ra] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT Glandular lesions of the urinary bladder include a broad spectrum of entities ranging from completely benign glandular lesions to primary and secondary malignancies. Common benign bladder lesions that exhibit glandular differentiation include cystitis cystica, cystitis glandularis, von Brunn nests, nephrogenic adenoma, intestinal metaplasia, urachal remnant, endometriosis, and prostatic-type polyp. The World Health Organization defines primary adenocarcinoma of the bladder as an epithelial malignancy with pure glandular differentiation without evidence of typical urothelial carcinoma. Malignant lesions that should be included in the differential diagnosis of a primary adenocarcinoma of the bladder include noninvasive and invasive urothelial carcinoma with glandular differentiation and secondary malignancies involving the bladder by direct extension or metastasis. The recognition and distinction of these different entities may be a challenge for pathologists, but they are of great clinical importance. OBJECTIVE To review features of primary bladder adenocarcinoma as well as those entities that need to be differentiated from primary bladder adenocarcinoma, with emphasis on clinical findings, pathologic characteristics, and immunoprofiles. DATA SOURCES Selected original articles published in the PubMed service of the US National Library of Medicine. CONCLUSIONS The accurate diagnosis of adenocarcinoma of the urinary bladder is important and challenging. It has to prompt an extensive clinical workup to rule out other glandular lesions in the urinary bladder, especially the possibility of secondary involvement of the bladder by an adenocarcinoma from a different site.
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Affiliation(s)
- Minghao Zhong
- Department of Pathology, Northwestern Memorial Hospital, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, USA
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26
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Abstract
PURPOSE OF REVIEW Urothelial carcinoma is the most common histological type of bladder tumours. Nevertheless, its variants and less common types represent 20% of all bladder cancers. The objective was to update the recent publications on these rare diseases and to draw conclusions for clinical management. RECENT FINDINGS Recent retrospective studies have been published. They refine the description of histological patterns and of immunochemistry diagnosis. Taking into account the heterogeneity of these pathologies, several groups have benefited of increased knowledge such as sarcomas and lymphomas. The need of international collaboration to study prospectively some subgroups of tumours is crucial. SUMMARY Rare bladder cancers have generally poor outcome and in a majority of the cases surgery, namely cystectomy remains the most important curative treatment. Specific subgroups, as lymphoma, sarcoma and dedifferentiated epithelial tumours may benefit of molecular characterization and trials with targeted drugs.
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27
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Cho SY, Moon KC, Cheong MS, Kwak C, Kim HH, Ku JH. Localized resectable genitourinary sarcoma in adult Korean patients: experiences at a single center. Yonsei Med J 2011; 52:761-7. [PMID: 21786440 PMCID: PMC3159947 DOI: 10.3349/ymj.2011.52.5.761] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To evaluate the clinicopathological characteristics and prognosis of localized resectable genitourinary sarcomas in adults. MATERIALS AND METHODS Between September, 1996 and November, 2008, 18 consecutive cases of adults (12 men and 6 women; median age 48.8 years) who were treated for primary genitourinary sarcomas were identified. The following variables were analyzed: patient age, gender, body mass index, American Society of Anesthesiologists (ASA) score, primary organ, tumor histology, size, necrosis, Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC) grade, and surgical margin positivity. Recurrence- free survival and disease-specific survival were the study end-points. RESULTS The most common presenting symptom was a palpable mass (six cases, 33.3%), the most common site was the kidney (six cases, 33.3%), and the most common histological subtype was leiomyosarcoma (eight patients, 44.4%). Complete resection with negative surgical margins was achieved in 13 patients (72.2%). The median follow-up period was 49.9 months (range 6.4 to 147.6). The recurrence- free survival rates at 1, 3, and 5 years were 81.6%, 66.5%, and 66.5%, respectively. Recurrence-free survival only associated significantly with ASA score (p=0.018). The disease-specific survival rate at 1, 3, and 5 years was 88.9%, 76.2%, and 67.7%, respectively. Disease-specific survival was associated significantly only with FNCLCC grade (p=0.042). CONCLUSION Although genitourinary sarcomas in adults are a rare group of tumors with a poor prognosis, some patients may have a favorable prognosis. Our findings suggest that FNCLCC grade is the most important prognostic factor for these patients.
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Affiliation(s)
- Sung Yong Cho
- Department of Urology, Seoul National University Hospital, Seoul, Korea
| | - Kyung Chul Moon
- Department of Pathology, Seoul National University Hospital, Seoul, Korea
| | - Min Su Cheong
- Department of Urology, Seoul National University Hospital, Seoul, Korea
| | - Cheol Kwak
- Department of Urology, Seoul National University Hospital, Seoul, Korea
| | - Hyeon Hoe Kim
- Department of Urology, Seoul National University Hospital, Seoul, Korea
| | - Ja Hyeon Ku
- Department of Urology, Seoul National University Hospital, Seoul, Korea
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28
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Chalasani V, Chin JL, Izawa JI. Histologic variants of urothelial bladder cancer and nonurothelial histology in bladder cancer. Can Urol Assoc J 2011; 3:S193-8. [PMID: 20019984 DOI: 10.5489/cuaj.1195] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Bladder cancer can be classified histologically as urothelial or non-urothelial. Urothelial cancer has a propensity for divergent differentiation, which has increasingly been recognized in recent years due to heightened awareness and improved immunohistochemistry techniques. Furthermore, the recent World Health Organization classification of urothelial cancers improved clarity on this issue, with its listing of 13 histologic variants of urothelial cancer. The divergent differentiation patterns include, amongst others, squamous, glandular, micropapillary, nested, lymphepithelioma-like, plasmacytoid and sarcomatoid variants of urothelial cancer. Attempts to quantify the amount of divergent differentiation present, such as using the nonconventional differentiation number, have been made recently, which will improve the ability to compare publications from different centres. Genetic-based studies have indicated that the histologic variants of urothelial cancer arise from a common clonal precursor. Mostly, the current evidence suggests that urothelial cancer with divergent differentiation has a worse prognosis when compared with pure urothelial cancer. This article will review the current literature on variant histologies of urothelial cancer, and well as new developments in pure squamous cell carcinoma, small cell carcinoma and adenocarcinoma of the bladder.
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Affiliation(s)
- Venu Chalasani
- Departments of Surgery & Oncology, Divisions of Urology & Surgical Oncology, London Health Sciences Centre-Victoria Hospital, London, ON
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29
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Vishnu P, Mathew J, Tan WW. Current therapeutic strategies for invasive and metastatic bladder cancer. Onco Targets Ther 2011; 4:97-113. [PMID: 21792316 PMCID: PMC3143909 DOI: 10.2147/ott.s22875] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Bladder cancer is one of the most common cancers in Europe, the United States, and Northern African countries. Muscle-invasive bladder cancer is an aggressive epithelial tumor, with a high rate of early systemic dissemination. Superficial, noninvasive bladder cancer can most often be cured; a good proportion of invasive cases can also be cured by a combined modality approach of surgery, chemotherapy, and radiation. Recurrences are common and mostly manifest as metastatic disease. Those with distant metastatic disease can sometime achieve partial or complete remission with combination chemotherapy. RECENT DEVELOPMENTS Better understanding of the biology of the disease has led to the incorporation of molecular and genetic features along with factors such as tumor grade, lympho-vascular invasion, and aberrant histology, thereby allowing identification of 'favorable' and 'unfavorable' cancers which helps a more accurate informed and objective selection of patients who would benefit from neoadjuvant and adjuvant chemotherapy. Gene expression profiling has been used to find molecular signature patterns that can potentially be predictive of drug sensitivity and metastasis. Understanding the molecular pathways of invasive bladder cancer has led to clinical investigation of several targeted therapeutics such as anti-angiogenics, mTOR inhibitors, and anti-EGFR agents. CONCLUSION With improvements in the understanding of the biology of bladder cancer, clinical trials studying novel and targeted agents alone or in combination with chemotherapy have increased the armamentarium for the treatment of bladder cancer. Although the novel biomarkers and gene expression profiles have been shown to provide important predictive and prognostic information and are anticipated to be incorporated in clinical decision-making, their exact utility and relevance calls for a larger prospective validation.
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Affiliation(s)
- Prakash Vishnu
- Division of Hematology Oncology, Mayo Clinic, Jacksonville, FL, USA
| | - Jacob Mathew
- Division of Hematology Oncology, Mayo Clinic, Jacksonville, FL, USA
| | - Winston W Tan
- Division of Hematology Oncology, Mayo Clinic, Jacksonville, FL, USA
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30
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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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Rapid progression of a urinary bladder leiomyosarcoma: report of a case. Case Rep Urol 2011; 2011:532081. [PMID: 22606617 PMCID: PMC3350187 DOI: 10.1155/2011/532081] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2011] [Accepted: 06/12/2011] [Indexed: 11/17/2022] Open
Abstract
The case we report shows rapid progression and a very poor prognosis only for a month that differs from the clinical course reported in the literature. An 83-year-old man was referred to our hospital for macroscopic hematuria. Computed tomography (CT) revealed a large bladder tumor measuring 4 cm × 3 cm and magnetic resonance imaging revealed extravesical invasion and pelvic wall invasion of the tumors. Chest CT and bone scintigraphy revealed no evidence of distant visceral metastases, and a clinical diagnosis of T4N0M0 was made. Transurethral resection of the bladder tumor (TUR-BT) was performed for histopathological diagnosis 18 days after admission, and no further adjuvant treatment was given. At 15 days after TUR-BT, the patient's clinical status worsened with symptoms of exertional dyspnea. CT showed multiple metastatic lesions in the lung, liver, and retroperitoneal lymphadenopathy. The patient died 2 days later and underwent autopsy. A final histopathological diagnosis of leiomyosarcoma was made based on immunohistochemical staining.
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Liu ZW, Zhang XQ, Hou GL, Zhang ZL, Qin ZK, Han H, Zhou FJ. Primary adult intratesticular rhabdomyosarcoma: results of the treatment of six cases. Int J Urol 2010; 18:171-4. [PMID: 21272089 DOI: 10.1111/j.1442-2042.2010.02685.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim of the present study was to assess the treatment outcomes in a cohort of adult patients with intratesticular rhabdomyosarcoma. Between 1999 and 2008, 296 patients underwent radical orchiectomy for intrascrotal mass. A retrospective chart review was carried out for adult patients diagnosed with intratesticular rhabdomyosarcoma. Overall, six patients (mean age 21 years, range 17-23) were included: five had embryonic rhabdomyosarcoma and one had pleomorphic rhabdomyosarcoma. Four patients underwent retroperitoneal lymph node dissection and five patients had postoperative chemotherapy. The mean length of follow up was 28 months (range 12-51 months). One patient was lost to follow up after 26 months, five cases remained alive at the end of the study. Surgical resection with chemotherapy was an effective way to achieve favorable outcomes and long-term survival in adult patients with metastases from intratesticular rhabdomyosarcoma.
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Affiliation(s)
- Zhuo-Wei Liu
- Department of Urology, Cancer Center, Sun Yat-Sen University, Guangzhou, Guangdong, 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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Ricciardi E, Maniglio P, Schimberni M, Moscarini M. A case of high-grade leiomyosarcoma of the bladder with delayed onset and very poor prognosis. World J Surg Oncol 2010; 8:16. [PMID: 20302611 PMCID: PMC2847558 DOI: 10.1186/1477-7819-8-16] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2009] [Accepted: 03/19/2010] [Indexed: 02/02/2023] Open
Abstract
Mesenchymal tumors represent a small number of bladder cancer cases. Leiomyosarcoma is the most common histology with over 100 cases reported in the whole literature. This tumor is been historically considered as highly aggressive and showing a poor prognosis. Despite very low survival rates showed in older reports, some authors indicate that some patients could have a better outcome. We report a review of the literature and a case of high-grade LMS of the bladder in a 68 years old woman. Diagnosis was delayed and disease was locally advanced. Symptoms and imaging of our case first oriented to a gynecologic condition with an adnexal or uterine origin of the mass, and, a genitourinary origin could be unveiled only intra-operatively.
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Affiliation(s)
- Enzo Ricciardi
- Department of Gynecology, Perinatology and Child Health, Sapienza University of Rome, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00195 Rome, Italy.
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35
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36
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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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Abstract
Vascular tumors of the bladder are rare and a subject of small series and case reports. We retrospectively identified vascular tumors of the urinary bladder from the consultation files from one of the authors. We identified 13 lesions that included 3 hemangiomas, 3 intravascular papillary endothelial hyperplasias (Masson vegetant hemangioendotheliomas), 2 arteriovenous malformations (AVMs), 1 epithelioid hemangioendothelioma (EHE), and 4 angiosarcomas. One of the angiosarcomas was associated with conventional high-grade urothelial carcinoma (sarcomatoid carcinoma). All patients were adults with a range in age from 18 to 85 years old (mean 63.3). There was no statistical difference among the various lesions in terms of age, although angiosarcomas tended to arise in older patients (mean 71 y vs. 60 y of the remainder). Hematuria was the most common presentation of both benign and malignant lesions. Other symptoms included voiding irritation, pelvic pain, and obstruction. Histologically, benign and malignant lesions were similar to their counterparts in other organ systems. Two hemangiomas were of the capillary type and a third one of the cavernous subtype. They measured 1.1, 2.4, and 3.2 cm. Both AVMs were clinically large broad-based masses measuring 5.5 and 5.8 cm in greatest diameter. One of the AVMs was associated with pseudoepitheliomatous hyperplasia of the urothelium. All 3 patients with Masson lesion had history of radiation therapy for other causes. These presented as raised lesions and were all <1.0 cm. Patients with hemangiomas, papillary endothelial hyperplasias, and AVM had an invariably benign prognosis and needed no further therapy. These benign lesions had consistent involvement of the submucosa and spared the muscularis propria of the organ. All cases of angiosarcoma and EHE involved the muscularis propria. Two of four patients with angiosarcoma had a history of prior radiation therapy and all 4 were dead of disease at 6 months. Angiosarcomas measured 3, 4.5, 5, and 5.8 cm in greatest diameter at cystoscopy. The patient with EHE had a single nodule treated by transurethral resection of the bladder and no evidence of disease at 4 years of follow-up. None of the patients experienced marked gross hematuria that resulted in morbidity or mortality. A wide spectrum of benign, intermediate malignant, and malignant vascular lesions primarily involved the bladder. Despite the potential for marked hemorrhage, none of the tumors resulted in marked hematuria. Papillary endothelial hyperplasia occurs in the bladder and must be differentiated from angiosarcoma, which has a rapidly fatal outcome.
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Childs L, Hull D, Bostwick DG. Adult urinary bladder rhabdomyosarcoma. Urology 2008; 72:948.e1-3. [PMID: 18400279 DOI: 10.1016/j.urology.2008.01.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2007] [Revised: 12/26/2007] [Accepted: 01/07/2008] [Indexed: 11/15/2022]
Abstract
Rhabdomyosarcomas, malignant neoplasms exhibiting skeletal muscle differentiation, are the most common childhood sarcomas and most commonly arise in the head-and-neck region. Embryonal rhabdomyosarcomas of the genitourinary tract also occur in children, but are distinctly uncommon in adults. We report a case of embryonal rhabdomyosarcoma arising in the bladder of a 39-year-old woman who presented with urgency, frequency, and gross hematuria.
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Affiliation(s)
- Lane Childs
- Western Urological Clinic, Salt Lake City, Utah, USA
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39
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Lee JW, Park SC, Rim JS. Leiomyosarcoma at the Ureterovesical Junction. Korean J Urol 2008. [DOI: 10.4111/kju.2008.49.9.855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Jea Whan Lee
- Department of Urology, Wonkwang University School of Medicine, Institute of Wonkwang Medical Science, Iksan, Korea
| | - Seung Chol Park
- Department of Urology, Wonkwang University School of Medicine, Institute of Wonkwang Medical Science, Iksan, Korea
| | - Joung Sik Rim
- Department of Urology, Wonkwang University School of Medicine, Institute of Wonkwang Medical Science, Iksan, Korea
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Labanaris AP, Zugor V, Meyer B, Nützel R, Helmus S, Labanaris PG, Kühn R. Urinary bladder leiomyosarcoma in adults. Int Urol Nephrol 2007; 40:311-6. [PMID: 17922107 DOI: 10.1007/s11255-007-9288-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2007] [Accepted: 09/04/2007] [Indexed: 02/02/2023]
Affiliation(s)
- Apostolos P Labanaris
- Department of Urology, Martha Maria Medical Center, Stadenstrasse 58, 90409 Nurnberg, Germany.
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Lott S, Lopez-Beltran A, Montironi R, MacLennan GT, Cheng L. Soft tissue tumors of the urinary bladder Part II: malignant neoplasms. Hum Pathol 2007; 38:963-977. [PMID: 17574946 DOI: 10.1016/j.humpath.2007.03.016] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2007] [Accepted: 03/20/2007] [Indexed: 02/02/2023]
Abstract
Most bladder tumors arise from the urothelium. However, there are several uncommon but significant malignant bladder lesions that must be differentiated from urothelial carcinomas and from benign lesions of the bladder. The second half of this two-part review will describe rare nonurothelial malignant tumors of the urinary bladder including leiomyosarcoma, rhabdomyosarcoma, angiosarcoma, malignant fibrous histiocytoma (undifferentiated sarcoma), primitive neuroectodermal tumor, malignant peripheral nerve sheath tumor, hemangiopericytoma, and alveolar soft-parts sarcoma. Common clinical presentations, morphologic characteristics, and immunohistochemical features are described to aid the practicing pathologist in the identification of these entities. Because the distinction between malignant and benign lesions has significant therapeutic and prognostic implications, key factors for differentiating them are presented.
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Affiliation(s)
- Sarah Lott
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Antonio Lopez-Beltran
- Department of Urology, Indiana University School of Medicine, Indianapolis, IN 46202, USA; Department of Pathology, Cordoba University, E-14004 Cordoba, Spain
| | - Rodolfo Montironi
- Institute of Pathological Anatomy and Histopathology, School of Medicine, Polytechnic University of the Marche Region (Ancona), United Hospitals, 60020 Ancona, Italy
| | - Gregory T MacLennan
- Department of Pathology, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Liang Cheng
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA; Department of Urology, Indiana University School of Medicine, Indianapolis, IN 46202, USA; Department of Pathology, Cordoba University, E-14004 Cordoba, Spain.
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