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Case Reports
. 2017 Mar 21:2017:bcr2016218642.
doi: 10.1136/bcr-2016-218642.

Carcinosarcoma of the bladder following local schistosomiasis infection

Victor Srougi  1 , Fabio P Gallucci  1 , Romulo L Mattedi  2 , Miguel Srougi  1
Affiliations
Case Reports

Carcinosarcoma of the bladder following local schistosomiasis infection

Victor Srougi et al. BMJ Case Rep. .

Abstract

A young patient from central Africa presented acute renal insufficiency due to extrinsic compression of the distal ureters by a pelvic mass. After initial medical management, a biopsy revealed poorly differentiated bladder cancer and Schistosoma haematobium eggs embedded in the bladder wall. The initial workup showed evidence of locoregional disease. Radical cystectomy with an incontinent urinary diversion was performed with no complications. Carcinosarcoma of the bladder was diagnosed by pathological analysis of the surgical specimen. After a short follow-up, the patient was readmitted presenting with lung and bone metastases. At 60 days after diagnosis, he died of respiratory insufficiency caused by pulmonary metastatic disease.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Non-contrast CT revealing (A) a solid mass in the bladder lumen and calcification in the bladder wall corresponding to Schistosoma haematobium eggs (yellow arrow) and (B) bilateral hydronephrosis associated with loss of parenchyma of the left kidney.
Figure 2
Figure 2
(A) Multiple pulmonary metastases (yellow arrow) are noted in thorax CT. (B) Paravertebral muscular metastases (yellow arrow) are shown in MRI.
Figure 3
Figure 3
Pathological assessment of the cystectomy specimen (×200): (A) transition spindle cell tumour and dysplastic epithelium (H&E stain), (B) Schistosoma haematobium eggs between neoplastic cells (yellow arrow; H&E stain), (C) immunohistochemistry for cytokeratin 5 revealing diffuse positivity and (D) immunohistochemistry for Ki-67 demonstrating a high index of cell proliferation.
See this image and copyright information in PMC

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