A case of high-grade leiomyosarcoma of the bladder with delayed onset and very poor prognosis

Department of Gynecology, Perinatology and Child Health, Sapienza University of Rome, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00195 Rome, Italy.
World Journal of Surgical Oncology (Impact Factor: 1.41). 03/2010; 8(1):16. DOI: 10.1186/1477-7819-8-16
Source: PubMed


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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Available from: Enzo Ricciardi
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    • "The databases of Pubmed and Hinari were searched using the keywords 'bladder', 'leiomyosarcoma' and 'smooth muscle neoplasm'. This review includes the 14 articles identified, comprising 77 cases (Table 1 [1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] [12]). "
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    ABSTRACT: Objectives To review the published cases of leiomyosarcoma of the urinary bladder and to report two further cases. Methods The databases Pubmed and Hinari were searched using the keywords ‘bladder’, ‘leiomyosarcoma’ and ‘smooth muscle neoplasm’. The 14 articles identified were reviewed, and we present a further two cases. Results Of more than 100 cases reported, 77 were reviewed. There is a lack of consensus about the standard treatment, and little is known about the natural history and prognosis of the tumour, due to its very low incidence. These tumours occur in older adults of either sex and are characterised by an aggressive behaviour. There is usually an unfavourable outcome, with the lungs being the most common site of metastasis. The two further cases we report had a different presentation and outcome. Conclusions Because of the limited experience with this rare tumour, there are insufficient data to suggest the optimum management strategy and prognosis.
    Full-text · Article · Jun 2013 · Arab Journal of Urology
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    • "Patients with positive surgical margin could be candidates for adjuvant radiotherapy. Patients with local recurrence or metastatic bladder sarcomas should be treated with systemic chemotherapy (as sarcoma chemotherapy protocol using doxorubicin, ifosfamide, cisplatin, and docetaxel), and/or radiotherapy [4] [5]. Contemporary studies suggest that these tumors may have a better prognosis than once believed and show remarkable 5-year-disease-specific survival rates of 59– 62% [2] [4]. "
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    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.
    Full-text · Article · Jul 2011
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    ABSTRACT: A 28-year-old woman with a history of prior bilateral retinoblastoma presented with general fatigue, anemia, and a urinary bladder mass seen on abdominal ultrasound and CT. She was referred for a staging F-FDG PET/CT, which showed an intensely FDG-avid bladder mass that was biopsied to reveal a leiomyosarcoma, with no evidence of metastases, which guided her management. F-FDG PET/CT is routinely used in the evaluation of leiomyosarcomas; however, its use in the staging of a leiomyosarcoma of the urinary bladder has not been previously described in the literature. This case highlights the usefulness of PET/CT in the staging of this rare tumor.
    Full-text · Article · Jan 2013 · Clinical nuclear medicine
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