Boutaggount Farah, Maskrout Meryem, Mokfi Rania, Rais Ghizlane
Medical Oncology Department, Faculty of Medicine and Pharmacy of Agadir, Souss Massa University Hospital Centre, University Ibn Zohr, Agadir, Morocco.
Radiol Case Rep. 2022 Aug 16;17(10):3982-3986. doi: 10.1016/j.radcr.2022.07.027. eCollection 2022 Oct.
The coexistence of 2 primary bladder tumors of different histogenesis is very rare. Synchronous leiomyosarcoma LMS of the bladder and urothelial carcinoma are even rarer. We report here the case of a 48-year-old patient who presented with hematuria and symptoms of bladder irritation. Cystoscopy showed a superficial bladder tumor which occupies the entire bladder lumen. Transurethral resection of bladder tumor (TURBT) was performed and revealed a noninvasive low-grade papillary urothelial carcinoma pTa with nonvisualized muscularis. A second TURBT could not remove any muscle. The decision for a radical cystectomy was performed with Bricker derivation and pelvic lymph node dissection to control bleeding. The final pathology demonstrated concurrent urothelial carcinoma and leiomyosarcoma LMS. In this report, we presented a unique case of urinary bladder leiomyosarcoma with noninvasive urothelial carcinoma. The rarity of this association and its clinical similarity to other common tumors, including infiltrative urothelial tumors, leading to misdiagnosis, are also described.
两种不同组织发生的原发性膀胱肿瘤共存极为罕见。膀胱平滑肌肉瘤（LMS）与尿路上皮癌同时存在的情况更为罕见。我们在此报告一例48岁患者，其表现为血尿和膀胱刺激症状。膀胱镜检查显示一个占据整个膀胱腔的浅表膀胱肿瘤。行经尿道膀胱肿瘤切除术（TURBT），结果显示为非侵袭性低级别乳头状尿路上皮癌pTa，未见肌层。再次TURBT未能切除任何肌肉组织。决定行根治性膀胱切除术并采用Bricker术式及盆腔淋巴结清扫以控制出血。最终病理显示同时存在尿路上皮癌和平滑肌肉瘤LMS。在本报告中，我们呈现了一例伴有非侵袭性尿路上皮癌的膀胱平滑肌肉瘤的独特病例。还描述了这种关联的罕见性及其与其他常见肿瘤（包括浸润性尿路上皮肿瘤）在临床上的相似性，这可能导致误诊。
