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Badheeb AM, Alkhanbashi O, Al Hammadi SS, Ahmed F, Guzailan H, Baslasel OS, Bin Dahman L, Alyami NH, Abu Bakar A, Badheeb M. Urinary Bladder Carcinosarcoma (Sarcomatoid Carcinoma) With Long Survival After Transurethral Resection: A Case Report. Cureus 2024; 16:e59992. [PMID: 38854258 PMCID: PMC11162261 DOI: 10.7759/cureus.59992] [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: 05/09/2024] [Indexed: 06/11/2024] Open
Abstract
Carcinosarcoma or sarcomatoid carcinoma of the urinary bladder is a rare but aggressive bladder cancer characterized by malignant epithelial and mesenchymal components, with only a few cases reported in the literature so far. In this report, we discuss a case of a 74-year-old female nonsmoker who presented with intermittent hematuria and passage of clots in the last four months. Radiographic images showed an irregular mass lesion (6.2 x 6 cm) in the left lateral wall of the urinary bladder near to left vesicoureteral junction. The mass was completely removed with transurethral resection of the bladder tumor (TUR-BT). Histopathological study revealed high-grade carcinosarcoma, and immunohistochemistry showed diffuse positivity for vimentin, pan-cytokeratin (CK) and CK7, epithelial membrane antigen (EMA), and CK5/6. The patient declined radical cystectomy and only agreed to receive intravesical chemotherapy (gemcitabine), and she remains alive after more than four years of follow-up. Carcinosarcoma of the urinary bladder is a rare tumor primarily affecting older people, and it is most commonly treated with radical cystectomy and different combination treatments such as chemotherapy and radiation. However, tumor resection followed by intravesical chemotherapy may be an alternative option in the early stages of bladder carcinosarcoma for some patients, thereby avoiding the need for aggressive treatments, especially for elderly patients who decline to undergo radical surgery.
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Affiliation(s)
- Ahmed M Badheeb
- Medicine, Hadhramout University, Mukalla, YEM
- Oncology, King Khalid Hospital - Oncology Center, Najran, SAU
| | | | | | | | | | - Omar S Baslasel
- Urology, National Institute of Urology and Nephrology Egypt, Cairo, EGY
| | - Lotfi Bin Dahman
- Clinical Biochemistry, College of Medicine, Hadhramout University, Mukalla, YEM
| | | | | | - Mohamed Badheeb
- Internal Medicine, Bridgeport Hospital, Yale New Haven Health, Bridgeport, USA
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Kouhen F, Dahbi Z, Afif M, Chihabeddine M, Errafiy N, Oqbani K, Omor Y, Elhossini A. Bladder carcinosarcoma treated by cystectomy and adjuvant chemotherapy with good outcomes: a case report. J Med Case Rep 2023; 17:320. [PMID: 37464254 DOI: 10.1186/s13256-023-04028-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 06/06/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Primary carcinosarcoma of the bladder is a rare and highly aggressive tumor, representing less than 1% of all bladder neoplasms. There is no specific treatment guideline has for carcinosarcoma of the bladder, and majority of published patients was treated exclusively by surgery. CASE PRESENTATION We report a case of 65-year-old Moroccan man, presented with macroscopic hematuria, pollakiuria and painful urination. Histological analysis showed a biphasic epithelial and mesenchymal proliferation, with invasion of lamina propria and muscularis, compatible with diagnosis of bladder carcinosarcoma. The patient was treated with cystectomy and adjuvant chemotherapy based on gemcitabin-cisplatin, 18 months after treatment, patient still free of recurrence. CONCLUSION Carcinosarcoma of the urinary bladder is a rare and aggressive tumor regardless treatment. A multidisciplinary management based on radical cystectomy and combined adjuvant treatments can improve prognosis. In this work, we suggest to propose adjuvant chemotherapy whenever possible.
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Affiliation(s)
- Fadila Kouhen
- Department of Radiotherapy, International University Hospital Sheikh Khalifa, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco.
| | - Zineb Dahbi
- Department of Radiotherapy, International University Hospital Sheikh Khalifa, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
| | - Mohammed Afif
- Department of Radiotherapy, Faculty of Medicine of Tangier, Abdelmalek Essaadi University, Tangier, Morocco
| | - Meriem Chihabeddine
- Department of Radiotherapy, International University Hospital Sheikh Khalifa, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
| | - Nadia Errafiy
- National Reference Laboratory (LNR), Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
| | - Kenza Oqbani
- Pathology Laboratory, International University Hospital Sheikh Khalifa, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
| | - Youssef Omor
- Department of Radiology, National Institute of Oncology, Rabat, Morocco
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Liu L, Zhu J, Tian Y. Carcinosarcoma is an aggressive subtype of bladder cancer: A population-based study. Cancer Med 2022; 11:2216-2223. [PMID: 35179304 PMCID: PMC9160804 DOI: 10.1002/cam4.4611] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 11/15/2022] Open
Abstract
Background Case reports of bladder carcinosarcoma (BCS) indicate high rates of recurrence and metastasis and poor prognosis. However, the differences in clinicopathologic characteristics and prognosis between BCS and conventional bladder cancer histologies (transitional cell carcinoma [TCC], squamous cell carcinoma [SCC] and adenocarcinoma [AC]) have not been fully clarified in a large study. Therefore, we conducted a large population‐based study to further investigate these differences. Patients and methods Information on patients with BCS and conventional bladder cancer (TCC, SCC or AC) was extracted from the Surveillance, Epidemiology, and End Results database. Categorical variables were compared using Pearson's chi‐squared test or Fisher's exact test. Survival analysis was carried out using the Kaplan–Meier method, and differences in survival were assessed using the log‐rank test. Propensity score matching analysis was conducted to calibrate the differences between the baseline characteristics, after which Cox regression analysis was applied to calculate the hazard ratios and 95% confidence intervals of BCS compared to other subtypes. Subgroup analysis and related interaction were tested to evaluate the consistency and heterogeneity of results. Results We enrolled 152 patients with BCS and 180,196 patients with TCC, SCC or AC. Our results showed that BCS was associated with poor differentiation, advanced stage and an unfavourable overall survival and cancer‐specific survival. BCS had a worse prognosis than TCC and AC, but no statistically significant difference in survival was noted between BCS and SCC. Conclusions BCS is a more aggressive bladder cancer than TCC and AC but is comparable to SCC. These findings broaden our understanding of BCS and may be helpful in clinical practice.
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Affiliation(s)
- Lin Liu
- Zhaoqing Medical College, Zhaoqing, China
| | - Jinglan Zhu
- The Central Hospital of Shaoyang, Shaoyang, China
| | - Yun Tian
- Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, China
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Eberhard J, Hirsch D, Schilling O, Dirks WG, Guo F, Fabarius A, Rückert F, Reißfelder C, Hohenberger P, Pallavi P. First report on establishment and characterization of a carcinosarcoma tumour cell line model of the bladder. Sci Rep 2021; 11:6030. [PMID: 33727576 PMCID: PMC7971026 DOI: 10.1038/s41598-021-85400-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 02/09/2021] [Indexed: 11/09/2022] Open
Abstract
Carcinosarcoma of the urinary bladder is a very rare and aggressive subtype of bladder cancer with poor prognosis. Characteristically carcinosarcomas exhibit biphasic nature with both epithelial and mesenchymal differentiation. Limited information is available regarding its clinical features and appropriate treatments due to its rarity. Development of tumour models can further our understanding of bladder carcinosarcoma. We report establishment and characterization of the first-ever bladder carcinosarcoma cell line MaS-3. It is established by the outgrow method from 86 year-old caucasian male who underwent a radical pelvic resection after neoadjuvant radiotherapy. MaS-3 showed carcinosarcoma profile with high conformity with to the original tumour in terms of immunocytochemistry. Proteome analysis also aligned the MaS-3 cell line with the carcinosarcoma specimen rather than corresponding non-malignant tissue. Chemotherapy sensitivity testing revealed a great sensitivity of MaS-3 growth to 5-Fluorouracil, Gemcitabine and Cisplatin, with almost no impact of Irinotecan. Additionally, the suitability of MaS-3 for 3D in vitro experiments was also demonstrated. The newly established cell line MaS-3 shows typical characteristics of the tumour and may thus be a useful in vitro model system for studying the tumour biology and developing future of treatments of this rare but very aggressive entity.
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Affiliation(s)
- Johannes Eberhard
- Surgical Department, University Hospital Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Daniela Hirsch
- Institute of Pathology, University Hospital Mannheim, Heidelberg University, Mannheim, Germany
| | - Oliver Schilling
- Institute of Surgical Pathology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Deutsches Konsortium für Translationale Krebsforschung, Standort Freiburg, Freiburg, Germany
| | - Wilhelm G Dirks
- Department of Human and Animal Cell Lines, Leibniz-Institute DSMZ-German Collection of Microorganisms and Cell Cultures, Braunschweig, Germany
| | - Feng Guo
- Surgical Department, University Hospital Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Alice Fabarius
- Department of Haematology and Oncology, University Hospital Mannheim, Heidelberg University, Mannheim, Germany
| | - Felix Rückert
- Surgical Department, University Hospital Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
| | - Christoph Reißfelder
- Surgical Department, University Hospital Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Peter Hohenberger
- Division of Surgical Oncology and Thoracic Surgery, Medical Faculty Mannheim, University Hospital Mannheim, University of Heidelberg, Mannheim, Germany
| | - Prama Pallavi
- Surgical Department, University Hospital Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
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