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Review
. 2013 Jun;11(2):159-64.
doi: 10.1016/j.aju.2013.03.004. Epub 2013 May 6.

Leiomyosarcoma of the urinary bladder: A review and a report of two further cases

Nader Y Hamadalla  1 , Usama N Rifat  2 , Khalid C Safi  1 , Mustafa Mohammed  3 , Hussam Abu-Farsakh  4
Affiliations
Review

Leiomyosarcoma of the urinary bladder: A review and a report of two further cases

Nader Y Hamadalla et al. Arab J Urol. 2013 Jun.

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.

Keywords: FNCLCC, Fédération Nationale des Centres de Lutte Contre le Cancer; HPF, high-power fields; Leiomyosarcoma; MSKCC, Memorial Sloan Kettering Cancer Center; Management; Outcome; Urinary bladder.

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Figures

Figure 1
Figure 1
CT showing a large mass at the right lower wall of the bladder, encroaching upon the bladder neck.
Figure 2
Figure 2
Microscopic findings of the leiomyosarcoma, showing spindle-shaped cells with marked atypia (Haematoxylin and eosin, ×400).
Figure 3
Figure 3
Microscopic findings of the leiomyosarcoma, showing pleomorphic cells with a high mitotic count of 20/10 HPF (Haematoxylin and eosin, ×400).
Figure 4
Figure 4
Immunostaining of the tumour for: (A) actin (positive); (B) desmin (a few positive cells); (C) uroplakin (negative); and (D) uroplakin III (negative).
None
See this image and copyright information in PMC

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