Department of Urology, Osaka National Hospital, Hoenzaka 2-1-14, Osaka, 540-0006, Japan.
Department of Pathology, Osaka National Hospital, Osaka, Japan.
J Med Case Rep. 2022 Mar 25;16(1):118. doi: 10.1186/s13256-022-03346-2.
Osteosarcoma arising from the bladder is extremely rare, with only 38 cases reported to our knowledge. It is often detected owing to hematuria, and is treated by surgery (for example, total cystectomy), radiation therapy, and chemotherapy; however, the prognosis is extremely poor.
An 83-year-old Japanese man underwent cystoscopy for postoperative follow-up of urothelial carcinoma of the bladder, which revealed a 2-cm nodular tumor on the right wall. He had a history of abdominal aortic aneurysm and hypertension, and had been smoking 15 cigarettes per day for 45 years. Seven years previously, the patient underwent transurethral resection of bladder tumor for a 5-cm tumor on the right wall of the bladder. The histopathological diagnosis was urothelial carcinoma. No recurrence had been detected since then. Transurethral resection of bladder tumor was performed, and the histopathological diagnosis was cystosarcoma. Because of his advanced age, we decided that it would be difficult to perform total cystectomy. We therefore performed a second transurethral resection of bladder tumor and found no residual tumor. At 29 months after surgery, the patient remains alive without recurrence.
Bladder osteosarcoma has a poor prognosis. However, our case was detected early, and treatment with transurethral resection of bladder tumor alone resulted in long-term survival without recurrence.
膀胱癌起源的骨肉瘤极为罕见,据我们所知,仅有 38 例报告。它通常因血尿而被发现,并通过手术(例如全膀胱切除术)、放射治疗和化疗进行治疗;然而,预后极差。
一位 83 岁的日本男性因膀胱癌的术后随访而行膀胱镜检查,发现右侧壁有一个 2 厘米大的结节状肿瘤。他有腹主动脉瘤和高血压病史,每天吸烟 15 支,已经吸了 45 年。7 年前,患者因右侧壁 5 厘米大的膀胱肿瘤行经尿道膀胱肿瘤切除术。组织病理学诊断为尿路上皮癌。此后未发现复发。行经尿道膀胱肿瘤切除术,组织病理学诊断为膀胱骨肉瘤。由于患者年龄较大,我们认为行全膀胱切除术难度较大。因此,我们再次行经尿道膀胱肿瘤切除术,未发现肿瘤残留。术后 29 个月,患者仍存活且无复发。
膀胱骨肉瘤预后不良。然而,我们的病例发现较早,单独行经尿道膀胱肿瘤切除术治疗后长期生存且无复发。