Leiomyosarcoma of the urinary bladder: A review and a report of two further cases

Abstract

ObjectivesTo review the published cases of leiomyosarcoma of the urinary bladder and to report two further cases.MethodsThe databases Pubmed and Hinari were searched using the keywords ‘bladder’, ‘leiomyosarcoma’ and ‘smooth muscle neoplasm’. The 14 articles identified were reviewed, and we present a further two cases.ResultsOf more than 100 cases reported, 77 were reviewed. There is a lack of consensus about the standard treatment, and little is known about the natural history and prognosis of the tumour, due to its very low incidence. These tumours occur in older adults of either sex and are characterised by an aggressive behaviour. There is usually an unfavourable outcome, with the lungs being the most common site of metastasis. The two further cases we report had a different presentation and outcome.ConclusionsBecause of the limited experience with this rare tumour, there are insufficient data to suggest the optimum management strategy and prognosis.

Surgical management for giant bladder leiomyosarcoma

“…Bladder leiomyosarcoma is a rare malignancy that accounts for only 0.1% of bladder lesions. 1 Given the rarity of this tumor, there has not been a consensus on standard treatment pathways, and there is limited data to guide clinical decision making. Our case is notable due to the massive size of tumor and lack of neoadjuvant treatment.…”

The First Case of Metastatic Pancreatic Leiomyosarcoma Derived from the Urinary Bladder Diagnosed Using an Endoscopic Ultrasound-guided Fine-needle Biopsy

“…Non-epithelial tumors account for less than 5% of bladder malignancies, and leiomyosarcomas are even rarer, accounting for only 0.1% of bladder malignancies (9). In a study of postoperative outcomes of bladder leiomyosarcoma, Spiess et al noted local recurrence in 16% of cases and distant metastases in 53%, most frequently to the lungs, bones, liver, or brain (10).…”

Total endoscopic management of a patient with urinary bladder leiomyosarcoma presenting with dysuria: A case report

“…The lungs, liver, bone, and brain are the most common sites of metastases. 4 Reportedly, it has a specific five-year survival rate of 62%, and a recurrence rate of 34% in 38 months. No general consensus exists for treatment, but it is regarded as a highly aggressive entity that requires an aggressive surgical extirpation with wide margins.…”

“…That report indicated that although bladder leiomyosarcoma has always been regarded as a highly aggressive tumor, partial surgery is now considered a reliable option because it preserves function and decreases aggressiveness. 4 …”

“…Herein, we present the case of total endoscopic management of a patient with urinary bladder leiomyosarcoma presenting with dysuria. 1 , 2 , 3 , 4 …”