Primary angiosarcoma of urinary bladder: 13th reported patient

Abstract

Angiosarcoma of the urinary bladder is an extremely rare and poorly characterized tumor. We are presenting the 13th reported patient who was an 89-year-old man initially presented with massive hematuria. His past medical history included external-beam radiation for prostate cancer 12 years ago. His PSA was 0.26 ng/dL. His CT-Urography demonstrated a highly vascular mass originating from the bladder base. The mass was partially resected, transurethrally. The pathology was consistent with primary angiosarcoma of the urinary bladder. Bone scan and CT-U showed metastasis to spine. The patient was treated with palliative radiotherapy for back pain due to metastasis, and he refused chemotherapy. The patient died 3 months after his initial diagnosis.

Figure 1

Computed tomography of our patient. (a) Highly vascular mass originating from the left bladder wall, but a prostatic origin could not be absolutely rolled out by CT. (b) Hydronephrosis on the left side and coronal view of the mass.

Figure 2

Histopathology and immunohistochemistry. (a) Typical appearance of anastomosing vascular channels as seen with H&E. (b) Tumor cells stain positive for CD34. (c) Tumor cells stain positive for CD31. (d) Tumor cells do not stain for cytokeratin.