Coexisting Transitional Cell Carcinoma and Leiomyosarcoma in the Urinary Bladder: A Case Report

Abstract

Smooth muscle neoplasms of the urinary bladder are rare, and the majority of them are leiomyosarcomas followed by leiomyomas of conventional histopathological type. Simultaneous occurrence of transitonal cell carcinoma and sarcoma as two separate primary tumors in the bladder is very rare. A new case of coexisting leiomyosarcoma and transitional cell carcinoma of the urinary bladder is presented.C Ca as se e R Re ep po or rt t A 65-year old man presented with a threemonth history of painless gross hematuria, dysuria, urinary frequency and nocturia. An intravenous pyelography revealed normal upper urinary tract and a filling defect on the left lateral wall of the bladder. Pelvic computed tomography (CT) showed two solid papillary masses measuring 4x5 cm and 2x2 cm on the posterolateral wall of the bladder. No retroperitoneal adenopathy or metastases were found. Cystoscopic examination revealed a 4x5 cm polypoid, broad-based tumor on the left-posterior wall of the bladder. In addition, a 2x2 cm smooth polypoid mass with intact surface was determined above this tumor. These tumors were resected transurethrally and intravesical mitomycin-C was administered as a single instillation. Pathological examination revealed T1, grade 2 papillary transitional cell carcinoma and focal muscle invasive leiomyosarcoma, respectively ( figure 1 and figure 2). Transitional cell carcinoma was composed of a central fibrovascular core that is covered by 8-10 - ---------------------------------------------------------------------------------------------------