Baschinsky D Y, Chen J H, Vadmal M S, Lucas J G, Bahnson R R, Niemann T H
Department of Pathology, The Ohio State Univerity Medical Center and Arthur G. James Cancer Hospital and Research Institute, Columbus, Ohio 43210-1240, USA.
Arch Pathol Lab Med. 2000 Aug;124(8):1172-8. doi: 10.5858/2000-124-1172-COTUBA.
Carcinosarcomas of urinary bladder are rare malignant neoplasms. Seventy-eight cases have been previously described. The histologic composition of these tumors is variable, but diagnosis requires the presence of both epithelial and mesenchymal malignant components. We report 4 additional cases, with an emphasis on unusual histologic features.
Histologic and immunohistochemical examinations were performed on bladder tumors from 4 patients. Clinicopathologic features of previously reported and current cases were reviewed and summarized.
Four patients (3 men, 1 woman) age 54 to 77 years were found to have polypoid masses in the urinary bladder. In all cases, histologic examination showed biphasic neoplasms with distinct mesenchymal and epithelial components. The morphologic and immunohistochemical characteristics of the tumors varied. One of the cases was remarkable for the presence of liposarcoma, malignant peripheral nerve sheath tumor, and micropapillary urothelial carcinoma. Two of the patients died 2 years after diagnosis, which is consistent with the previously reported aggressive nature of urinary bladder carcinosarcomas.
Carcinosarcomas of the urinary bladder are rare, aggressive malignant neoplasms. To our knowledge, a liposarcomatous component has been reported in only 1 case previously, and components of micropapillary urothelial carcinoma and malignant peripheral nerve sheath tumor have not been reported previously in carcinosarcomas of the urinary bladder. Because of the aggressive biologic behavior of these tumors, they should be identified promptly and treated appropriately.
膀胱癌肉瘤是罕见的恶性肿瘤。此前已报道过78例。这些肿瘤的组织学构成各不相同，但诊断需要同时存在上皮和间叶恶性成分。我们报告另外4例，重点关注其不寻常的组织学特征。
对4例患者的膀胱肿瘤进行了组织学和免疫组化检查。回顾并总结了先前报道病例和当前病例的临床病理特征。
4例患者（3男1女），年龄54至77岁，均在膀胱内发现息肉样肿物。所有病例的组织学检查均显示为具有明显间叶和上皮成分的双相性肿瘤。肿瘤的形态学和免疫组化特征各不相同。其中1例的特点是存在脂肪肉瘤、恶性外周神经鞘瘤和微乳头型尿路上皮癌。2例患者在诊断后2年死亡，这与先前报道的膀胱癌肉瘤的侵袭性本质相符。
膀胱癌肉瘤是罕见的、侵袭性恶性肿瘤。据我们所知，此前仅报道过1例含有脂肪肉瘤成分的病例，而微乳头型尿路上皮癌和恶性外周神经鞘瘤成分此前尚未在膀胱癌肉瘤中报道过。由于这些肿瘤具有侵袭性生物学行为，应及时识别并进行适当治疗。
