Primary osteogenic sarcoma of the urinary bladder successfully treated with combination therapy.

A 54-year-old woman presented with a large bladder mass and left hydroureteronephrosis. At radical cystectomy (with ileal loop urinary diversion), an unresectable left obturator mass was found. Combination chemotherapy postoperatively resulted in significant shrinkage, and she underwent excision of the residual mass. No residual cancer was seen. The patient remains free of disease 56 months after cystectomy and 51 months after resection of the residual mass. Primary osteogenic sarcoma of the urinary bladder may respond to combination chemotherapy and surgery. All patients found to have advanced disease should be considered for this approach.