Akoluk Arda, Barazani Yagil, Slova Denisa, Shah Sovrin, Tareen Basir
Yeditepe University School of Medicine, Istanbul,Turkey.
Can Urol Assoc J. 2011 Aug;5(4):E69-73. doi: 10.5489/cuaj.10161.
Primary osteosarcomas of the bladder account for about 0.04% of bladder neoplasms. Most of the patients in the literature expired within 6 months and, in almost all of the cases in the literature, radical cystectomy with postoperative chemotherapy was the treatment choice. A 79-year-old gentleman presented with gross hematuria. Cystoscopy demonstrated a 2- to 3-cm tumour along the lateral wall of the bladder. The tumour was resected incompletely via initial transurethral resection of bladder tumour (TURBT), and a second TURBT was subsequently performed to fully resect the residual mass. Surgical pathology from these 2 resections revealed osteosarcoma with invasion into the muscularis propria. A cystoprostatectomy was performed and final pathologic specimen revealed high-grade CIS without evidence of residual osteosarcoma. Postoperatively, the patient did not receive chemotherapy or radiation and currently remains disease-free 2 years post-radical cystectomy. Only 33 well-documented cases of primary osteosarcoma of the bladder have been reported to date. However, there are only 3 cases in which TURBT resulted in complete resection.
膀胱原发性骨肉瘤约占膀胱肿瘤的0.04%。文献中的大多数患者在6个月内死亡,并且在文献报道的几乎所有病例中,治疗选择都是根治性膀胱切除术加术后化疗。一名79岁男性因肉眼血尿就诊。膀胱镜检查发现膀胱侧壁有一个2至3厘米的肿瘤。最初通过经尿道膀胱肿瘤切除术(TURBT)对肿瘤进行了不完全切除,随后又进行了第二次TURBT以完全切除残留肿块。这两次切除的手术病理显示为骨肉瘤,侵犯至固有肌层。进行了膀胱前列腺切除术,最终病理标本显示为高级别原位癌,无残留骨肉瘤证据。术后,患者未接受化疗或放疗,目前在根治性膀胱切除术后2年仍无疾病。迄今为止,仅报道了33例有充分记录的膀胱原发性骨肉瘤病例。然而,只有3例经TURBT实现了完全切除。