Deka Phanindra Mohan, Bagawade Jaynil A, Deka Pallavi, Baruah Ronica, Shah Naushad
Department of Urology, Dispur Hospitals Pvt. Ltd., Guwahati, Assam, India.
Department of Urology, Dispur Hospitals Pvt. Ltd., Guwahati, Assam, India.
Urology. 2017 Aug;106:e15-e18. doi: 10.1016/j.urology.2017.05.008. Epub 2017 May 11.
To study the first reported case of intravesical angiomyofibroblastoma (AMFB). AMFB is an uncommon benign mesenchymal lesion, mostly described in the lower female genital tract, especially in the vulva and less commonly in the vagina. It is rarely seen in the male genital tract. The importance of this rare neoplasm is related to its potential mimicry of more infiltrative and prognostically less favorable lesions, such as aggressive angiomyxomas, that are found in the same anatomic area.
A 26-year-old man presented to us with hematuria. Investigations revealed an intraluminal polypoidal lesion of approximately 92 × 77 × 76 mm within the urinary bladder. Cystoscopy revealed a large well-circumscribed tumor with a pedicle, attached to the inferolateral wall of the bladder near the bladder neck. Open exploration and en bloc excision of the bladder mass was done.
Histopathology and immunohistochemistry (IHC) confirmed the diagnosis of AMFB.
AMFB presents as a well-circumscribed superficial mass. Complete excision of the tumor for histopathologic and IHC examination is essential for diagnosis. This rare tumor shows morphologic similarity to some more aggressive tumors with less favorable outcome; hence, it needs to be differentiated from those. IHC is helpful but not always conclusive in the diagnosis of this rare neoplasm. This being the first-ever reported case of intravesical AMFB bears a significant importance. Careful clinical assessment, operative management, and histopathologic examination are of utmost importance in making a precise diagnosis and management of the patient.
研究首例膀胱内血管肌纤维母细胞瘤（AMFB）病例。AMFB是一种罕见的良性间叶性病变，大多描述于女性下生殖道，尤其是外阴，较少见于阴道。在男性生殖道中罕见。这种罕见肿瘤的重要性与其可能酷似在同一解剖区域发现的更具浸润性且预后较差的病变有关，如侵袭性血管黏液瘤。
一名26岁男性因血尿前来就诊。检查发现膀胱内有一个约92×77×76mm的腔内息肉样病变。膀胱镜检查显示一个带蒂的、边界清晰的大肿瘤，附着于膀胱颈附近膀胱的下外侧壁。对膀胱肿物进行了开放探查并整块切除。
组织病理学和免疫组化（IHC）确诊为AMFB。
AMFB表现为边界清晰的浅表肿物。完整切除肿瘤进行组织病理学和免疫组化检查对诊断至关重要。这种罕见肿瘤在形态上与一些预后较差的侵袭性更强的肿瘤相似；因此，需要将其与那些肿瘤区分开来。免疫组化在诊断这种罕见肿瘤时是有帮助的，但并不总是具有决定性意义。这是首例报道的膀胱内AMFB病例，具有重要意义。仔细的临床评估、手术处理和组织病理学检查对于准确诊断和治疗患者至关重要。
