Case Report on Hemangioma of The Urinary Bladder: two rare cases and literature review

Abstract

<jats:title>Abstract</jats:title> <jats:p><jats:bold>Background: </jats:bold>Although hemangioma in the genitourinary system occurs relatively infrequently, bladder hemangioma has arisen during medical research. We describe two rare cases of urinary bladder hemangioma (UBH), in which was confirmed histopathology followed by Immunohistochemistry (IHC) and review the literature on the diagnosis and treatment of patients with this disease to raise awareness of urinary bladder hemangioma and appropriate management.<jats:bold>Case presentation: </jats:bold>A 41-year-old Chinese female presented with a sudden onset of painless gross hematuria for one month, Multi-Slice spiral computed tomography urography in the urological system showed the anterior and superior wall thickening of the bladder, multiple nodules and masses, exhibited multiple punctate calcifications and marked uneven enhancement. The second case is a 30-year-old female who was asymptomatic and incidentally founded a large bladder tumor during a routine examination from outside hospital, magnetic resonance imaging scan confirmed a 6.2cm x 6.9cm x 5.2cm soft tissue mass arising from the right anterior and superior wall of the bladder, which suggested the possibility of a benign bladder tumor. Postoperative pathology confirmed the diagnosis of urinary bladder hemangioma<jats:bold>. </jats:bold>The radical cystectomy was performed with open-methods surgery associated with an abdominal wall ostomy of the ileal outlet tract for case 1. And case 2 finally underwent a Laparoscopic partial cystectomy. Hematuria resolved postoperatively and no evidence of tumor recurrence in three year follow-ups for case 1. Postoperative urinary and pelvic ultrasonography showed no signs of recurrence in three months follow-ups for case 2.<jats:bold>Conclusion:</jats:bold> Urinary bladder hemangioma is a benign non-urothelial tumor that rarely occurred in pediatric and adolescent patients . Clinical and radiological examinations are not adequate for an accurate diagnosis. Careful histopathological and immunohistochemical studies are required to establish the correct diagnosis. There is no ‘gold standard’ treatment for UBH, treatment options are varied for individuals with favorable follow-ups.</jats:p>

Urinary bladder cavernous hemangioma in a 3‐year‐old: A rare case report

“…Our case developed recurrent anemia, obstructive uropathy and urosepsis (evidence by neutrophilic leukocytosis), justifying surgical approach. Treatment options usually involve observation, transurethral resection, electrocoagulation, radiation, systemic steroids administration, injection of a sclerosing agent, interferon‐alpha‐2 therapy, laser therapy, and partial cystectomy or complete cystectomy 2,15 . Bladder CH is histologically similar to hemangiomas found at other sites with numerous proliferative capillaries mixed with thin‐walled, dilated blood‐filled vessels lined with flattened endothelium 16 …”

Urinary Bladder Cavernous Hemangioma in a 3-year-old: A rare case report.

“…CH are benign vascular tumors rarely encountered in the genitourinary tract (1). It is the most common histological form of urinary bladder hemangiomas, with the other forms being capillary and arteriovenous type (2,3). Bladder hemangiomas result from embryological remains of unipotent angioblastic cells that develop in an anomalous way inside the blood vessels (5).…”

“…Bladder hemangiomas result from embryological remains of unipotent angioblastic cells that develop in an anomalous way inside the blood vessels (5). Hemangioma of the urinary bladder are rare accounting for 0.6% of all bladder tumors occurring in all ages, but they are less common during childhood and adolescence (2)(3)(4). For children with bladder hemangioma, systemic evaluation is highly recommended because 3-5% coexist with other genetic syndromes such as cutaneous hemangiomas, Klippel-Trenaunay syndrome, Sturge-Weber syndrome, encephalo-trigeminalangiomatosis, Rendu-Osler-Weber disease, hemorrhagic telangiectasia syndrome and systemic angiomatosis (1-3, 5).…”

“…INTRODUCTION: CH of urinary bladder occurs relatively infrequently, accounting for 0.6% of all bladder tumors (2)(3)(4). Bladder hemangiomas result from embryological remains of unipotent angioblastic cells that develop in an anomalous way inside the blood vessels (5).…”

“…Bladder hemangiomas result from embryological remains of unipotent angioblastic cells that develop in an anomalous way inside the blood vessels (5). This tumor may occur sporadically or coexist with other benign and malignant vascular lesions such as cutaneous hemangiomas, Klippel-Trenaunay syndrome, Sturge-Weber syndrome, encephalo-trigeminal-angiomatosis, Osler-Weber-Rendu-disease, hemorrhagic telangiectasia syndrome and systemic angiomatosis (1)(2)(3)5). CH should be considered in the differential diagnosis of childhood genitourinary masses.…”