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Case Reports
. 2024 May 29;16(5):e61310.
doi: 10.7759/cureus.61310. eCollection 2024 May.

Bladder Leiomyoma in a 15-Year-Old Female Patient: A Case Report

Yunus Emre Genc  1 , Naif Dinc Ulker  1 , Muhammed Hasan Toper  2 , Selcuk Yucel  3 , Tarik Emre Sener  1
Affiliations
Case Reports

Bladder Leiomyoma in a 15-Year-Old Female Patient: A Case Report

Yunus Emre Genc et al. Cureus. .

Abstract

Bladder leiomyoma is a rare condition in pediatric and adolescent age groups, accounting for less than 1% of all bladder tumors, presenting a diverse array of histologic types and prevalence. Furthermore, bladder leiomyoma's prevalence is even more seldom with only five reported cases till the present day. Common presentation depends on the localisation and the affected layer in the bladder, urinary outlet or ureteral obstruction, irritative voiding symptoms, pelvic pain, and hematuria are the most common presentations of this condition. Diagnostic, treatment, and follow-up protocols in this entity are not well-established due to their rare occurrence in this age group. After complete surgical excision, the prognosis is excellent and the risk of recurrence is reported to be very low. Up to the present day, no instances of malignant transformation or metastasis have been documented in the literature. This case report aims to enhance current knowledge of the radiological, pathological, and clinical features of bladder leiomyoma in a 15-year-old female patient. The main complaint was lower urinary tract symptoms. An incidental solid bladder mass was discovered during the evaluation with ultrasound and magnetic resonance imaging (MRI). Afterwards, cystoscopy confirmed a 5-centimeter solid mass at the right wall of the bladder, and transurethral piecemeal resection was performed. The bladder mass was found to be intramural, and complete endoscopic resection was considered safe and efficient during the surgery. No complications or recurrence occurred in the postoperative setting.

Keywords: leiomyoma; pediatric; transurethral resection of bladder; treatment; urinary bladder neoplasms.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Pre-operative contrast-enhanced pelvic MRI T1 axial
Figure 2
Figure 2. Pre-operative contrast-enhanced pelvic MRI T1 coronal
Figure 3
Figure 3. Pre-operative contrast-enhanced pelvic MRI T2 axial
Figure 4
Figure 4. Pre-operative contrast-enhanced pelvic MRI T2 coronal
Figure 5
Figure 5. Cystoscopy
5-cm solid mass at the right wall of the bladder which had a normal-looking overlying mucosa.
Figure 6
Figure 6. Transurethral piecemeal resection with bipolar energy
Figure 7
Figure 7. Enucleation of tumor base
Figure 8
Figure 8. Appearance of enucleated tumor
Figure 9
Figure 9. Fulgurated tumor base
Figure 10
Figure 10. Histopathological examination
Transurethral resection revealed numerous tumor fragments composed of spindle cells arranged in a fascicular pattern within the specimen (marked with asterisks), along with a small amount of fragments including normal urothelium and bladder muscle (indicated by arrows).
Figure 11
Figure 11. Histopathological examination
The tumor consists of spindle uniform cells with low cellularity.
Figure 12
Figure 12. Immunohistochemistry of the specimen with desmin, SMA, FH
The tumor cells demonstrate expression for desmin (A) and smooth muscle actin (SMA) (B), as well as fumarate hydratase (FH) (C) (200X).
Figure 13
Figure 13. Post-operative contrast-enhanced pelvic MRI T1 axial
Figure 14
Figure 14. Post-operative contrast-enhanced pelvic MRI T1 coronal
See this image and copyright information in PMC

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