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Case Reports
. 2023 Sep:110:108735.
doi: 10.1016/j.ijscr.2023.108735. Epub 2023 Aug 28.

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

Bilel Saidani  1 , Ahmed Saadi  1 , Mohamed Ali Bedoui  2 , Selim Zaghbib  1 , Marouene Chakroun  1 , Riadh Ben Slama  1
Affiliations
Case Reports

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

Bilel Saidani et al. Int J Surg Case Rep. 2023 Sep.

Abstract

Introduction and importance: Our study aims to expose the experience of our department in dealing with bladder leiomyosarcomas and illustrate the management tools of this rare pathology.

Case presentation: We present a retrospective study of 4 cases of bladder leiomyosarcoma, gathered in the Department of Urology during the period of 1996-2022. All our patients were exclusively male and aged between 35 and 73 years. No history of pelvic irradiation nor chemotherapy was found in our patients. Three patients had high-grade leiomyosarcoma and pT2 stage whereas only one had a low-grade tumour. Three patients underwent radical treatment by cystoprostatectomy with extensive bilateral pelvic lymph node dissection and one patient was treated by endoscopic re-resection and endoscopic monitoring. We noticed 2 lymph nodes and liver metastasis recurrences in 2 patients treated by radical surgery while 2 patients didn't present recurrences at two years of follow-up.

Clinical discussion: To date, there is no clear and precise therapeutic approach for the treatment of bladder leiomyosarcoma. Little is known about the long term survival associated with these tumours. All studies agree that the prognosis for bladder leiomyosarcoma is poor, if not diagnosed early, especially those presenting with an undifferentiated tumour grade, distant metastatis and treated without surgical therapy.

Conclusion: Bladder leiomyosarcoma is a rare and highly aggressive tumour. The anatomopathological examination provides diagnosis and prognosis assessment. Radical surgery remains the most suitable therapeutic approach.

Keywords: Bladder cancer; Chemotherapy; Cystectomy; Leiomyosarcoma.

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Conflict of interest statement

Conflict of interest statement The authors state no conflitct of interest.

Figures

Fig. 1
Fig. 1
Bladder leiomyosarcoma on endoscopic resection samples. (HE × 100): *Fusiform tumour proliferation splitting the musculosa (HE × 250) a: Fusiform cells with enlarged nuclei showing no marked atypia, b: Focus of the tumour necrosis, c: Immunostaining with anti-H caldesmon.
Fig. 2
Fig. 2
Bladder leiomyosarcoma on cystoprostatectomy specimen (HE × 40): * regular bladder mucosa, oval form: mesenchymal proliferation dissecting the musculosa.
Fig. 3
Fig. 3
a Liver recurrence after radical surgery for bladder leiomyosarcoma. b Inguinal lymph node recurrence after radical surgery for bladder leiomyosarcoma.
See this image and copyright information in PMC

References

    1. Hamadalla N.Y., Rifat U.N., Safi K.C., et al. Leiomyosarcoma of the urinary bladder: a review and a report of two further cases. Arab. J. Urol. 2013;11:159–164. - PMC - PubMed
    1. Youssef K., Dembele O.N., Idriss Z., et al. Le léiomyosarcome de la vessie: à propos de 3 cas. Pan Afr. Med. J. 2018;30:19–21. (French) - PMC - PubMed
    1. Lindberg M.R., Fisher C., Thway K., et al. Leiomyosarcoma of the urinary bladder: a clinicopathological study of 34 cases. J. Clin. Pathol. 2010;63:708–713. - PubMed
    1. Rodríguez D., Preston M.A., Barrisford G.W., et al. Clinical features of leiomyosarcoma of the urinary bladder: analysis of 183 cases. Urol. Oncol. 2014;32:958–965. - PubMed
    1. Zieschang H., Koch R., Wirth M.P., et al. Leiomyosarcoma of the urinary bladder in adult patients: a systematic review of the literature and meta-analysis. Urol. Int. 2019;102:96–101. - PubMed

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