Abstract
Carcinosarcoma of the urinary bladder is a rare neoplasm that is composed of malignant epithelial and mesenchymal components. In these tumors, histogenesis and biological behaviour remain controversial. Approximately 70 cases have been reported in the literature, usually as case reports or a small series. A series of 221 cases using the Surveillance, Epidemiology and End Results (SEER) Program database has been reported recently. Optimal treatment is uncertain. Herein, we report a case of sarcomatoid carcinoma of urinary bladder of a farmer aged 84 years old with a year history of hematuria and dysuria. A transurethral resection of the tumor (TUR-T) revealed a carcinosarcoma. The patient underwent radical cystectomy, and there is no tumor recurrence for 15 months after treatments.
Highlights
Sarcomatoid carcinoma or carcinosarcoma (CS) is a rare neoplasm of the urinary bladder that is defined by the World Health Organization as a biphasic tumor consisting of malignant epithelial and mesenchymal components [1]
The carcinosarcoma of the bladder is more commonly seen in males, and male/female ratio is nearly 2 : 1. The disease appears in the seventh decade of life [3]
The mesenchymal element of carcinosarcoma lacks epithelial markers [2, 4], and patients with carcinosarcoma present at a more advanced stage and are at greater risk for death compared to patients with high-grade urothelial carcinoma [3]
Summary
Sarcomatoid carcinoma or carcinosarcoma (CS) is a rare neoplasm of the urinary bladder that is defined by the World Health Organization as a biphasic tumor consisting of malignant epithelial and mesenchymal components [1]. More than 70% of cases present with advanced stage and have a worse prognosis than conventional urothelial carcinomas [3]. The mesenchymal element of carcinosarcoma lacks epithelial markers [2, 4], and patients with carcinosarcoma present at a more advanced stage and are at greater risk for death compared to patients with high-grade urothelial carcinoma [3]. In cases of bladder carcinosarcoma, evidence supporting a monoclonal origin for the epithelial and mesenchymal components was revealed using loss of heterozygosity studies with microsatellite markers [5, 6], while there exists a hypothesis that multiclonal stem cells of the epithelial and mesenchymal components play a causative role. We report a case of bladder carcinosarcoma which was more than 10 cm in diameter
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