Leiomyosarcoma Of Urinary Bladder Research Articles

URINARY BLADDER LEIOMYOSARCOMA --- A RARE CAUSE OF HEMATURIA

Cases of bladder leiomyosarcoma represent 0.1% of all nonurothelial tumours. Nonurothelial neoplasms of the bladder account for <5% of all bladder tumours. Urinary bladder leiomyosarcoma is a very rare entity with few cases reported in the literature. Given its scarcity, little is known about its etiology and consensus lacking on therapeutic management. Here we present the case of a 36year old female patient diagnosed with bladder leiomyosarcoma and then treated with partial cystectomy of the bladder and bladder reconstruction with bilateral pelvic lymph node dissection..

Leiomyosarcoma of urinary bladder in a Shih Tzu dog.

A 10-year-old intact male Shih Tzu dog presented with hematuria. Double-contrast cystography revealed a polypoid filling defect at the apex of the urinary bladder. Ultrasonography revealed a heterogeneously hypoechoic intramural mass with minimal vascular flow beneath the submucosal layer. After partial cystectomy, a well-demarcated bladder leiomyosarcoma was diagnosed on histopathology. The patient was alive and well without any clinical signs, recurrence, or metastasis at the 29-month follow-up after the surgical removal of the bladder mass. Leiomyosarcoma should be considered as a differential diagnosis if mass-like lesions are observed in the urinary bladder, although this type of malignancy is rare in canines. Histopathological confirmation is important for predicting prognosis and determining further medical plans.

Leiomyosarcoma of urinary bladder with unusual recurrence in intestinal mucosa and peritoneum: a case report

BackgroundLeiomyosarcomas of urinary bladder constitute rare malignant sarcomas with very few cases reported in literature.Case presentationHere, we present a case of bladder leiomyosarcoma in a well-preserved female. She failed to respond to standard chemotherapy and had a rapidly downhill course with unusual metastases in anastomotic site and peritoneum soon after surgery. Despite multimodality management including resection of primary and metastatic site, systemic therapy and pelvic radiotherapy, our patient had dismal prognosis with an overall survival of 1.7 years.ConclusionLeiomyosarcomas of bladder are aggressive tumors and have a very poor prognosis; thus, future research should focus on optimizing more effective treatment regimes.

Surgical Management of Large Liver Metastases from Urinary Bladder Leiomyosarcoma

Abstract Leiomyosarcoma is a malignant tumor developed from the smooth muscle. It can arise in different sites especiallyin gastrointestinal tract (stomach, small bowel and colon), genitourinary tract (uterus, bladder and kidney) and the retroperitoneum (inferior vena cava) (1,2). It’s localization in the bladder is rare, representing 0.5% of all urinary bladder malignancies. There are over 210 cases reported in literature(3).Ten to 30% of the patients willpossibly develop metastases and the most common sites are lungs, liver and bone(4,5). There is no concensus on a standard treatment due to its very low incidence. We report here a rare case of a surgical management of large liver metastases from urinary bladder leiomyosarcoma.

Leiomyosarcoma of the urinary bladder: a case report

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.

Leiomyosarcoma of Urinary Bladder, A Review of Two Cases

Abstract Introduction/Objective Leiomyosarcomas of the urinary bladder are rare smooth muscle tumor, and constitute 1% of all bladder malignancies. Although rare, leiomyosarcoma is a clinically significant disease, presenting as a high-grade advanced malignancy with associated substantial morbidity and mortality, if not treated early. The diagnosis can be delayed because of the asymptomatic presentation until the tumor reaches an advanced stage. Methods We present two cases of leiomyosarcoma of the urinary bladder. First case: a 63 years old female with a history of cervical carcinoma treated with radiation, 25 years ago, followed by uncomplicated clinical course, until recent development of vesicovaginal fistula. During her work up with cystoscopy, a large bladder mass was identified. Second case: a 71 years old female with a history of treated breast cancer, who presented with recurrent history of cystitis and hematuria. Cystoscopy revealed a nodular mass in the right posterior bladder wall. Results Microscopically, both lesions were highly cellular with infiltrative, interlacing fascicles of spindle cells and associated mitosis, cellular atypia and necrosis. Immunohistochemistry revealed positive expression of muscle- specific actin, desmin, and caldesmon; with negative expression of ALK-1, EMA, Cytokeratins and GATA3, in both the cases. Other spindle cell lesions including, leiomyoma, inflammatory myofibroblastic tumor and sarcomatoid carcinoma were included in the differential diagnosis, and ruled out by morphology and immunohistochemistry. Conclusion Our cases highlight the importance of awareness of the occurrence of leiomyosarcomas, a rare manifestation in bladder. Although rare, but they present with a poor outcome. The differential diagnosis of spindle cell lesions is extensive, including close benign and malignant mimics, the treatment of all being very different. Immediate radical cystectomy has been associated with longer survival rates for leiomyosarcoma. Leiomyosarcoma, being aggressive, with associated high recurrence rate and metastatic potential, an early correct diagnosis would aid in the institution of proper management.

Leiomyosarcoma of Urinary Bladder in a Yorkshire Terrier Dog

A 13-year-old, intact male, Yorkshire terrier dog with oliguria and hematuria was presented to the Small Animal Clinic at the Gyeongsang National University animal medical center. There were no remarkable findings on serum chemistry values and complete blood counts. Abdominal radiographs revealed mild elevation of the descending colon at the pelvic level. On the excretory urographic images, a large filling defect was identified in urinary bladder with narrow urinary bladder wall contact and there were no remarkable findings in kidneys and ureters. The abdominal ultrasonography revealed that an irregularly marginated, heterogeneous mass in urinary bladder, central cavitary lesion and mild vascular flow were also observed. Computed tomography showed a heterogeneously attenuated mass within urinary bladder. The mass was surgically excised, and leiomyosarcoma was confirmed by histopathological examination. The patient was followed up for two months and there were no complications. This case is of interest because of the unusual findings of leiomyosarcoma of urinary bladder in a small breed dog.

Leiomyosarcoma of Urinary Bladder - a case report and review of the literature

Leiomyosarcoma of Urinary Bladder - a case report and review of the literature

Urinary bladder leiomyosarcoma with osteoclast-like multinucleated giant cells: a case report

BackgroundBladder leiomyosarcoma is the most frequent mesenchymal neoplasm of the bladder. However, the rarity of the disease and some morphological aspects could give serious problems to differential diagnosis.Case presentationA 86-year-old male patient was referred to our institution to undergo endoscopic low-urinary-tract re-evaluation 2 months after the detection of a “low-grade urothelial neoplasia” in urinary cytology. A TURBT (transurethral resection of bladder tumor) was performed and revealed a tumor extending for 3.5 cm with thin stalk peduncle on the left lateral wall of the bladder, cephalad and lateral to the left ureteral orifice. The exophytic part of the tumor was resected with the underlying bladder wall. Histologically, the tumor showed a quite complex pattern, composed of spindle cells, with often invasion to the surrounding bladder muscular wall, and the presence of numerous multinucleated, osteoclast-like giant cells, scattered throughout the neoplasia.ConclusionsHere we report a unique case of urinary bladder leiomyosarcoma with osteoclast-like multinucleated giant cells (OGCs). These cells, confounding the morphological aspect, indeed showed an immunohistochemical phenotype of non-neoplastic origin (most likely a histiocyte/macrophage differentiation). We feel that the presence of the OGCs within this tumor is reactive. Nevertheless, more research is necessary to understand the role of OGCs in urinary bladder tumors and leiomyosarcoma, in paticular.

Leiomyosarcoma of the Urinary Bladder in Adult Patients: A Systematic Review of the Literature and Meta-Analysis

Purpose: Leiomyosarcoma of the urinary bladder is exceedingly rare. Most clinicians come across only a few cases during their career, and information regarding treatment and outcome is scattered in the scientific literature. Interested clinicians and patients have to undertake troublesome search for treatment and outcome information. Material and methods: We performed a systematic review of the literature using the PubMed and Web of Science databases and included all identified cases published in English language between 1970 and June 2018 into a meta-analysis. Prior to the literature search, key questions were formulated and with the data obtained, answers to these questions should be derived. Results: We analyzed clinical data of 210 cases of urinary bladder leiomyosarcoma revealed by this review and seen in our institution. The mean age of patients was 52 years. The majority (75%) of the tumors was classified as high-grade sarcomas. We found no report of a prior radiation therapy to the pelvic organs, but some authors suggested an association between cyclophosphamide treatment and the development of bladder leiomyosarcoma, especially in patients with retinoblastoma. For the whole sample, we determined 5- and 10-year cancer-specific cumulative mortality rates of 38 and 50%. Patients with high-grade sarcomas had a trend toward a higher mortality compared with low-grade tumors (p = 0.0280). The most promising treatment option seems to be surgery (radical or partial cystectomy) with negative resection margins, possibly supplemented by chemotherapy or radiation. Conclusion: About half of patients with bladder leiomyosarcoma survived on the long run. Low-grade tumors may have a better outcome with, nevertheless, countable long-term mortality. For better assessment of that rare bladder tumor, its best treatment options, and the influence of neoadjuvant or adjuvant therapies on the outcome of patients, a larger series with long-term survival data is required.

Case report of leiomyosarcoma, a very rare type of urinary bladder tumour

Urinary bladder tumours account for approximately 1% of all tumours in dogs. The majority of them are epithelial in origin and malignant. Transitional cell carcinoma (TCC) is the most commonly diagnosed tumour of the urinary bladder. Malignant mesenchymal tumours in humans and animals are far less frequent than epithelial ones. Malignant mesenchymal urinary bladder tumours are represented by rabdomyosarcoma (RMS) and leiomyosarcoma (LMS). LMS occurs in older dogs, aged 7 - 12 years, and originates from the urinary bladder trigone and urethra, thus disturbing the urinary flow. LMSs are usually invasive, with a tendency to metastasize rapidly to the regional lymph nodes or abdominal organs, such as the liver, pancreas, kidneys, intestines and omentum. The aim of this report is to describe the clinical presentation, diagnostic approach and surgical treatment of the urinary bladder leiomyosarcoma that occurred in a Bernese Mountain Dog. The paper also highlights the latest diagnostic techniques for urinary bladder tumour detection, general rules of surgical resection and chemotherapy.

Bladder leiomyosarcoma in a patient with chronic ketamine abuse: A case report.

Bladder leiomyosarcoma is a rare mesenchymal tumour, accounting for less than 0.5% of all primary bladder malignancies. Adult women of reproductive age have the higher incidence of bladder leiomyosarcoma. Exposure to local pelvic radiotherapy or systemic chemotherapy, especially cyclophosphamide therapy, is also a significant risk factor. We describe a case of a 31-year-old male who developed urinary bladder leiomyosarcoma. The patient had no history of radiotherapy, systemic chemotherapy, or other significant event, except a 5-year history of ketamine abuse. The tumour was found on the left bladder wall and was definitively diagnosed by transurethral resection of the bladder tumour. A partial cystectomy was performed. There are no known reports of urinary bladder leiomyosarcoma associated with chronic ketamine abuse; therefore, we speculate that chronic ketamine abuse may be a factor in the development of this infrequent bladder malignancy.

Urinary bladder leiomyosarcoma following radiotherapy in a patient with bilateral retinoblastoma: A case report

Urinary bladder leiomyosarcoma following radiotherapy in a patient with bilateral retinoblastoma: A case report

A rare case report: atypical epithelioid leiomyosarcoma of urinary bladder

Background Benign and malignant mesenchymal tumours of the urinary bladder are rare. Non-epithelial tumours account for 1–2% of all primary urinary bladder neoplasms. Among them, leiomyosarcoma is the most common type, representing only 0.1% of bladder cancers. It has three distinct histological variants: the classical spindle cell subtype, the myxoid subtype and the rare epithelioid subtype.1 Case report A 54-year-old female became increasingly symptomatic with urge incontinence and gross haematuria associated with significant weight loss. Abdominal ultrasound showed a large mass in urinary bladder. Core biopsy and then radical cystectomy show sheets of atypical cells which are mostly epithelioid or polygonal in shape. The main differentials include epithelioid leiomyosarcoma, sarcomatoid carcinoma and other sarcomas. Immunostains for smooth muscle markers, calponin, h-caldesmon, SMA, cytokeratin stains, S100 stains, HMB45, c-kit and myoglobin stain were performed. Other immunomarkers of epithelioid tumours were also checked. Overall features are consistent with an epithelioid leiomyosarcoma with urinary bladder involvement. Discussion Epithelioid leiomyosarcoma is a very rare tumour of the urinary bladder. The use of immunohistochemical staining is of value in assisting diagnosis.

Clinical features of leiomyosarcoma of the urinary bladder: Analysis of 183 cases

IntroductionExperience with management of urinary bladder leiomyosarcoma (LMS) is rare. Therefore, to better elucidate the disease characteristics of urinary bladder LMS, we utilized a large population-based cancer registry to examine the epidemiology, natural history, pathological characteristics, prognostic factors, and treatment outcomes. Material and methodsThe Surveillance, Epidemiology, and End Results database (1973–2010) was used to identify cases by tumor site and histology codes. The association between clinical and demographic characteristics and long-term survival was examined. ResultsA total of 183 histologically confirmed cases were identified between 1973 and 2010. The annual age-adjusted incidence rate was 0.23 cases per 1,000,000 and did not significantly change over time. Median age of the patients was 65 years (interquartile range: 47–78y). Of the patients with a known pathologic tumor stage (n = 164), 50% had a regional or distant disease. Overall, 63.2% of patients with known histologic grade (n = 106), had poorly differentiated or undifferentiated histology. Most patients (92.9%) received cancer-directed surgery (CDS), with 34.4% having radical or partial cystectomy. Only 7.7% of patients received radiation therapy in combination with surgery. The median disease-specific survival was 46 months. Five- and 10-year cancer-specific survival rates were 47%, and 35%, respectively. On multivariate analysis, a worse outcome was associated with an undifferentiated tumor grade, distant disease, and failure to undergo CDS. ConclusionThis series represents the largest cohort of LMS of the urinary bladder studied to date. LMS commonly presented as high grade and advanced stage with a poor prognosis. Reduced disease-specific survival was associated with increasing age, undifferentiated tumor grade, distant disease, and failure to undergo CDS.

Urinary Bladder Leiomyosarcoma

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 18F-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. 18F-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.

Leiomyosarcoma of Urinary Bladder in Young Female Presenting with Gross Hematuria: Report of a Case

Gross hematuria is a common presentation of urinary tract infection in young females. Non-urothelial neoplasms of the bladder account for fewer than 5% of all bladder tumors. We present a case seen at the emergency department of our hospital, presenting with gross hematuria and symptoms of urinary tract infection. A comprehensive investigation revealed the presence of malignancy. The patient then underwent surgical treatment in the form of partial cystectomy. There are so far no signs of recurrence of the disease during the follow-up period for one year.

Rapid Progression of a Urinary Bladder Leiomyosarcoma: Report of a Case

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.

Urinary bladder leiomyosarcoma in adults

Non-urothelial neoplasms of the bladder account for fewer than 5% of all bladder tumors. Sarcoma constitutes the most usual mesenchymal malignancy of the bladder, with leiomyosarcomas being the most common type of sarcoma in adults. The records of seven patients presenting to two different institutions with bladder leiomyosarcomas between 2003 and 2007 and between 2000 and 2007, respectively, were examined. Cystoscopy, with transurethral resection of the bladder tumor was initially performed in all patients, with leiomyosarcoma being initially diagnosed on the basis of examination of the transurethral specimen. There were N = 5 men and N = 2 women with a median age of 64.8 years at presentation. All seven patients underwent a definitive surgical procedure. Complete resection with negative surgical margins was achieved in all seven patients (100%). MSKCC stage included 86% of patients with stage 3 (N = 6) and 14% with stage 2 (N = 1). A low-grade tumor was evident in one patient only, with the remaining 86% exhibiting a high-grade tumor. Leiomyosarcomas of the bladder have always been considered as a highly aggressive entity and little is known about their origin, clinicopathologic presentation, and the survival factors associated with them. Contemporary studies suggest that these tumors may have a better prognosis than once believed. Leiomyosarcomas require aggressive surgical extirpation and, when surgical resection is possible, radical cystectomy with wide margins is the rule and should be performed. Strict adherence to standard surgical technique has resulted in low rates of positive surgical margins and low rates of local tumor recurrence.

Locally advanced leiomyosarcoma of the urinary bladder: near-complete pathologic response to neoadjuvant gemcitabine and docetaxel

Leiomyosarcoma of the urinary bladder is a rare mesenchymal tumor with distinct pathologic features. Although radical cystectomy is the standard therapy for locally invasive disease, available literature appears to support the benefit of perioperative chemotherapy, similar to that seen with the more conventional urothelial malignancies. We report on a 77-year-old gentleman with locally advanced leiomyosarcoma of the bladder achieving a near-complete pathologic response to neoadjuvant chemotherapy with a unique regimen: gemcitabine and docetaxel. Further study of this anthracycline-sparing regimen is warranted.