Leiomyosarcoma of the urinary bladder: a case report

Abstract

OBJECTIVES: To describe a case of urinary bladder leiomyosarcoma (LMS), a rare malignant mesenchymal tumor. Less than 1% of primary bladder tumors are LMS, and only 200 cases have been reported in the literature, since the first description by Gusshaver, a century ago.METHODS: A radical cystoprostatectomy, using Bricker reconstruction and rectosigmoidectomy was performed. In the intraoperative period, an extensive and hypervascularized mass was found, involving the abdominal wall and compressing the ureters and iliac arteries bilaterally. Resection of the extensive bladder and prostate lesion was permormed in monobloc. The resected material was sent to anatomopathological analysis, which characterized a pleomorphic sarcoma fusiform cell type with necrosis, measuring 30x25x13 cm. After immunohistochemistry, a grade I (stage II in the TNM classification) leiomyosarcoma was evidenced.RESULTS: The patient remained hospitalized for 15 days in the Intensive Care Unit (ICU) after acute renal failure after surgery, requiring dialysis. He had a good evolution in the postoperative period, despite maintaining dialysis for chronic renal failure. On the 22nd postoperative day, he was constipated, but with a functioning Bricker and with no particularities in the surgical wound.CONCLUSION: Although the therapeutic approach to bladder LMS is not a consensus in the literature, a more radical treatment can be justified in the situation of an aggressive tumor, which often has a poor prognosis.