McNall Shannon, Park Terry, Gopal Nikhil, Spencer Evan, Vemulakonda Lakshmisree Akhila, Choudhury Muhammad, Wong Nathan Colin
New York Medical College, Valhalla, NY, United States.
Urologic Oncology Branch, National Cancer Institute, Bethesda, MD, United States.
Can Urol Assoc J. 2022 Nov;16(11):E563-E568. doi: 10.5489/cuaj.7745.
Urinary tract leiomyomas are rare, benign mesenchymal tumors that are traditionally treated with complete surgical excision. We present three cases of urinary tract leiomyoma - two located in the bladder and one in the ureter. Both bladder leiomyomas were treated with transurethral resection of bladder tumor (TURBT) with no evidence of recurrent disease, while the upper tract leiomyoma was managed with surveillance by patient preference, which to our knowledge, has not been previously described. The ureteral leiomyoma has remained stable at five years followup from initial diagnosis. Given the benign nature of leiomyomas and the overall low recurrence rate reported in the literature, bladder-sparing options should be emphasized when feasible, with active surveillance potentially applicable for highly select patients.
泌尿道平滑肌瘤是罕见的良性间叶组织肿瘤，传统上采用完整手术切除治疗。我们报告三例泌尿道平滑肌瘤病例，两例位于膀胱，一例位于输尿管。两例膀胱平滑肌瘤均采用经尿道膀胱肿瘤切除术（TURBT）治疗，无疾病复发证据，而上尿路平滑肌瘤根据患者意愿进行监测，据我们所知，此前尚无此类报道。输尿管平滑肌瘤自初次诊断后五年随访一直保持稳定。鉴于平滑肌瘤的良性性质以及文献报道的总体低复发率，可行时应强调保留膀胱的选择，主动监测可能适用于经过严格筛选的患者。
