Osteogenic leiomyosarcoma of the bladder

Primary malignant mesenchymoma of bladder: Case report and review of the literature

RATIONALE

Malignant mesenchymoma (MM) is defined as a heterogeneous malignant soft tissue tumor that consists of 2 or more distinctly different mesenchymal components in addition to fibrosarcomatous elements. Bladder MM was rarely reported in the literature and there are only 5 cases of primary bladder MM documented in English literature to date.

PATIENT CONCERNS

A 58-year-old male complained of difficulty in urination and intermittent gross hematuria for 3 months. Doppler ultrasound scan revealed an avascular and homogeneous hypoechoic mass measured 6.5 × 9 cm in the bladder. Computed tomography showed a homogeneous solid mass in the bladder.

DIAGNOSES

Pathology revealed spindle-shaped tumor and proliferation of poorly differentiated immature mesenchymal cells rich in eosinophilic cytoplasm with hyperchromatic sticklike nuclei. Immunohistochemical examinations were positive for CD117.

INTERVENTIONS

The patient was diagnosed with presence of bladder tumor and underwent radical cystectomy; the optimal treatment strategy was reviewed and discussed.

OUTCOMES

There was no recurrence or metastasis during a 16-month follow-up.

LESSONS

Our case study demonstrated bladder MM with a relatively indolent clinical course. A multidisciplinary approach including surgery, radiotherapy, and chemotherapy may be useful. Radical resection is the most important determinant of clinical outcome. Generally, the clinical outcome and prognosis of mesenchymoma are favorable.

Malignant mesenchymal tumor with leiomyosarcoma, rhabdomyosarcoma, chondrosarcoma, and osteosarcoma differentiation: case report and literature review

A case of malignant mesenchymoma of the bladder containing leiomyosarcoma, rhabdomyosarcoma, chondrosarcoma, osteosarcoma, and myxomatous components is described. The primary pedunculated tumor measuring 14 × 13 × 7 cm and weighing 343 g arose from the left trigone of the bladder and was treated by total cystectomy. The histogenesis of malignant mesenchymomas and their optimal management strategy and prognosis remain uncertain. Herein, we present the fifth case of malignant mesenchymoma of the urinary bladder to be reported in the literature, which presented five unrelated differentiated tissues more than did previously reported cases.

Primary mesenchymal tumors of the urinary bladder. A histological and immunohistochemical study of 30 cases

The light microscopic and immunohistochemical features of 30 primary mesenchymal neoplasms of the urinary bladder are reported. Half of the cases represented smooth and striated muscle tumors (five leiomyomas, seven leiomyosarcomas including epithelioid and myxoid subtypes, one rhabdomyoma, one embryonal rhabdomyosarcoma and one alveolar rhabdomyosarcoma). One third of the tumors were of fibrohistiocytic origin (one fibrous histiocytoma and eight malignant fibrous histiocytomas including fascicular and storiform, inflammatory and pleomorphic subtypes). In addition, a malignant epithelioid schwannoma, a round cell liposarcoma, two hemangiomas and two mixed mesodermal tumors were observed. The morphology of the vesical mesenchymal tumors was identical to that of their counterparts known to occur in other sites, particularly in the soft tissue. Muscle-specific actin, alpha-1-antichymotrypsin, S-100-protein and neuron-specific enolase proved to be useful and reliable immunomarkers for differential diagnosis of poorly differentiated leio- and rhabdomyosarcomas, malignant fibrous histiocytomas and malignant schwannomas. Since some tumors coexpressed several classes of intermediate filaments, diagnostic immunocytochemistry should only be used considering a larger panel of antibodies and in close correlation with the histological and cytological features of the neoplasms.

Malignant mesenchymoma of the bladder

A case of malignant mesenchymoma of the bladder, containing fibroleiomyomatous, myxomatous, osteoid, and cartilaginous components is presented. The primary pedunculated tumor measuring 18 X 10 X 9 cm and weighing 934 g, arose from the anterior wall of the bladder and was treated by partial cystectomy. Six months after surgery, cystoscopy revealed a recurrent tumor situated at the dome of the bladder. The patient received surgery, chemotherapy, and irradiation for recurrent tumor, but died of the disease 21 months after the first operation. Autopsy revealed extensive local recurrence with wide-spread metastases of malignant mesenchymoma of the bladder and an incidental finding of coexisting clear cell carcinoma in the right kidney (pTl, NO, MO). There have been no previous reports of association of malignant mesenchymoma of the urinary bladder and renal cell carcinoma.

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.

Primary osteogenic sarcoma of the bladder. Case report and review of the literature

Primary osteogenic sarcoma of the bladder is an extremely rare disease. Fewer than 30 cases of tumors of the bladder containing bone or cartilage have been reported. Only 14 cases of well-documented primary osteogenic sarcoma of the bladder appear in the world's literature. The authors describe the first detailed description of such a patient treated with radiotherapy and chemotherapy as well as provide a review of this rare and interesting entity.

Osteosarcoma of bladder 27 years after local radiotherapy

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Myosarcomas of the bladder and prostate

Of 32 patients seen in Memorial Center since 1920 with myosarcomas of the bladder or prostate 26 were male and six were female. The tumors arose in the bladder in 20, in the prostate in 11 and in one patient both organs were involved. Sarcomas of the bladder account for two or three of every thousand bladder cancers and for one of every thousand prostate cancers. Seventy-six patients, or approximately 10% of reported cases, have survived 3 years or more from diagnosis. Forty-five of those 76 sarcomas were reported as specific myosarcomas, i.e., embryonal rhabdomyosarcoma, adult rhabdomyosarcoma, leiomyosarcoma or combinations of those three. Thirty-six arose in the bladder, nine arose in the prostate. The most successful methods of treatment have been cystectomy for embryonal rhabdomyosarcoma of the bladder and segmental resection for leiomyosarcoma of the bladder. Rhabdomyosarcoma of the bladder and prostate has seldom been managed successfully, so that no particular treatment can be unconditionally recommended. Embryonal rhabdomyosarcoma of the prostate is as yet an incurable condition.