Department of Urology, Zigong First People's Hospital, Zigong, China.
Neurological Disease Laboratory, West China Hospital of Sichuan University, Chengdu, China.
BMC Urol. 2023 Mar 2;23(1):28. doi: 10.1186/s12894-023-01198-6.
Perivascular epithelioid cell tumor (PEComa) is a mesenchymal tumor with distinct histologic and immunologic features. PEComas that originate in the bladder are extremely rare clinically, with only 35 cases reported in the English literature thus far. Here, we report a case of bladder PEComa resection by transurethral en bloc resection of bladder tumor (ERBT).
A 66-year-old female with a history of poorly controlled type 2 diabetes with associated complications of frequent urinary tract infections presented to our hospital for a routine physical examination. Outpatient ultrasound examination revealed a strong echogenic mass of approximately 1.5 × 1.3 × 1.3 cm in size on the posterior wall of the bladder. The enhanced computed tomography and enhanced magnetic resonance imaging after admission both suggested a well-defined isolated nodular mass on the posterior wall of the bladder with significant enhancement on the enhanced scan. The tumor was successfully and completely resected by ERBT. Postoperative pathological examination and immunohistochemical results confirmed the mass was a bladder PEComa. No tumor recurrence was observed in the six-month postoperative follow-up.
Bladder PEComa is an extremely rare mesenchymal tumor of the urinary system. When imaging and cystoscopy reveal a nodular mass with an abundant blood supply in the bladder, PEComa should be included in the differential diagnosis of bladder tumors. Surgical resection is currently the primary option for the treatment of bladder PEComa. For a solitary, pedunculated, narrow-based, small-sized bladder PEComa, resection of the tumor by ERBT was a safe and feasible approach in our patient and may be considered for similar cases in the future.
血管周上皮样细胞瘤（PEComa）是一种具有独特组织学和免疫表型的间叶性肿瘤。起源于膀胱的 PEComa 临床上极为罕见，迄今为止，英文文献中仅报道了 35 例。本文报道了一例经尿道整块膀胱肿瘤切除术（ERBT）切除膀胱 PEComa 的病例。
一名 66 岁女性，患有 2 型糖尿病，控制不佳，伴有频繁尿路感染等并发症，因常规体检入我院就诊。门诊超声检查发现膀胱后壁有一个约 1.5×1.3×1.3cm 大小的强回声团。入院后的增强 CT 和增强 MRI 均提示膀胱后壁有一个界限清楚的孤立结节状肿块，增强扫描有明显强化。该肿瘤通过 ERBT 成功且完全切除。术后病理检查和免疫组化结果证实该肿块为膀胱 PEComa。术后 6 个月随访未见肿瘤复发。
膀胱 PEComa 是一种极为罕见的泌尿系统间叶性肿瘤。当影像学和膀胱镜检查显示膀胱内有一个富含血液供应的结节状肿块时，应将 PEComa 纳入膀胱肿瘤的鉴别诊断。目前，手术切除是治疗膀胱 PEComa 的主要选择。对于孤立、有蒂、基底较窄、体积较小的膀胱 PEComa，我们的患者通过 ERBT 切除肿瘤是一种安全可行的方法，未来可能会考虑用于类似病例。
