Osteosarcoma of bladder 27 years after local radiotherapy

Secondary Osteosarcoma of Pelvic Bone: Long-Term Complication of Bladder Cancer Radiotherapy

Second cancer in the irradiated area is one of the complication of radiotherapy of which bone and soft tissue sarcomas predominate. Radiation-induced osteosarcoma (RIOS)accounts for 3.4%–5.5% of all osteosarcoma cases. A 70-year old male presented with complaints of swelling and pain in left gluteal region without any antecedent trauma. On clinical examination 8 × 8 cm size swelling palpable in left gluteal region arising form left iliac bone. He had history of bladder carcinoma 20 years ago for which he received concurrent chemoradiation. CT scan showed a large, erosive and lytic lesion of left iliac bone and biopsy of the lesion was suggestive of osteosarcoma. In view of extensive lesion eroding left half of pelvic bone, surgery was not done, and chemotherapy was planned.

Urinary bladder radiotherapy-related chondroblastic osteosarcoma: Rare case report and review of literature

Radiation-related osteosarcomas are well described malignant mesenchymal neoplasms, yet their pathogenesis is not fully understood. They are generally classified into either skeletal osteosarcomas, or their and rare soft tissue counterpart. The occurrence of osteosarcoma in the urinary bladder (UB) following radiotherapy is exceedingly rare. To the best of our knowledge, only two cases of radiation-related urinary bladder osteosarcoma have been published; we herein describe another case of an 85-year-old man who developed post radiotherapy chondroblastic osteosarcoma of the urinary bladder four years following initial surgical resection and radiotherapy for bladder urothelial carcinoma. We believe that this is the first case of radiation-related chondroblastic osteosarcoma arising in the urinary bladder. In addition, we review the literature and explore the possible histogenesis of this rare neoplasm.

Carcinosarcoma of the bladder: case report and review of the literature

Primary osteosarcomas of the bladder account for about 0.04% of bladder neoplasms. Most of the patients in the literature expired within 6 months and, in almost all of the cases in the literature, radical cystectomy with postoperative chemotherapy was the treatment choice. A 79-year-old gentleman presented with gross hematuria. Cystoscopy demonstrated a 2- to 3-cm tumour along the lateral wall of the bladder. The tumour was resected incompletely via initial transurethral resection of bladder tumour (TURBT), and a second TURBT was subsequently performed to fully resect the residual mass. Surgical pathology from these 2 resections revealed osteosarcoma with invasion into the muscularis propria. A cystoprostatectomy was performed and final pathologic specimen revealed high-grade CIS without evidence of residual osteosarcoma. Postoperatively, the patient did not receive chemotherapy or radiation and currently remains disease-free 2 years post-radical cystectomy. Only 33 well-documented cases of primary osteosarcoma of the bladder have been reported to date. However, there are only 3 cases in which TURBT resulted in complete resection.

Osteosarcoma of the urinary bladder occurring simultaneously with prostate and bowel carcinomas: report of a case and review of the literature

Osteosarcoma is a very rare tumor of the urinary bladder, with only 28 well-documented cases reported in the literature to date. The tumors have characteristically been large and polypoid and most commonly have been located in the trigone. An abdominal mass has occasionally been palpated, and rectal examination has frequently revealed a mass in the region of the bladder. The prognosis for this tumor is very poor. In this report, a 75-year-old man with hematuria was found to have a primary osteosarcoma of the urinary bladder with superficial invasion. Radical cystoprostatectomy and ileal conduit urinary diversion were performed. During surgery, a synchronous mucinous adenocarcinoma of the ascending colon was found, and a right hemicolectomy was performed. Prostatic adenocarcinoma was discovered from the histology. The patient died 7 months after surgery with systemic spread of the osteosarcoma. Osteosarcoma of the bladder should be distinguished from other bladder tumors that may be associated with bone formation, such as carcinosarcomas and transitional cell carcinomas with osseous metaplasia of their stroma, both of which have a better prognosis than osteosarcoma.

Primary osteogenic sarcoma of the urinary bladder successfully treated with combination therapy

A 54-year-old woman presented with a large bladder mass and left hydroureteronephrosis. At radical cystectomy (with ileal loop urinary diversion), an unresectable left obturator mass was found. Combination chemotherapy postoperatively resulted in significant shrinkage, and she underwent excision of the residual mass. No residual cancer was seen. The patient remains free of disease 56 months after cystectomy and 51 months after resection of the residual mass. Primary osteogenic sarcoma of the urinary bladder may respond to combination chemotherapy and surgery. All patients found to have advanced disease should be considered for this approach.

Osteosarcoma of the urinary bladder. Report of a case and review of the literature

A 65-year-old man with hematuria had a large polypoid tumor of the urinary bladder which on microscopic examination was an osteosarcoma, only the 22nd example reported in this organ. The tumor was initially misinterpreted as a transitional cell carcinoma because of an absence of osteoid in the initial slide prepared from a biopsy of the neoplasm. Most of the patients with osteosarcoma of the bladder have been male; they have ranged from 41 to 83 (average 62) years of age. The tumors have characteristically been large and polypoid and have most commonly been located in the trigone. Follow-up is available for 21 patients; 18 of them died within 6 months or less. Three patients were still alive 14 months, 18 months, and 2 years postoperatively. Osteosarcoma of the bladder should be distinguished from other bladder tumors that may be associated with bone formation such as carcinosarcomas and transitional cell carcinomas with osseous metaplasia of their stroma, both of which have a better prognosis than osteosarcoma.