Myofibroblastic Inflammatory Tumors of the Bladder

Antonelli, Alessandro; Tanello, M.; Zanotelli, Tiziano; Frego, E.; Tardanico, Regina; Cunico, S. Cosciani

doi:10.1159/000075279

Cited by 4 publications

(3 citation statements)

References 3 publications

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“…Some authors query the utility of lengthy antibiotic therapy for pelvic actinomycosis [15] , if the abscess can instead be surgically removed, with subsequent shortterm therapy (less than 3 months), as in the case of our patient. At any rate, surgery may be advisable to prevent progression of the disease.…”

Section: Discussionmentioning

confidence: 84%

See 1 more Smart Citation

Intrauterine Device-Associated Actinomycosis of the Ovary and Urinary Bladder: A Case Report

Bottai

Marzi²,

Alessandrini³

et al. 2010

Urol Int

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Actinomycosis of the urinary bladder is rare, mostly subsequent to abdomino-pelvic infection, and usually affects women with long-term use of an intrauterine device. We describe a case of vesical actinomycosis mimicking a papillary bladder tumour in a 56-year-old woman with primary manifestation of the disease in the genital tract, subjected to two transurethral resections after relapse of a polypoid mass in the bladder. Urological procedures are necessary to differentiate actinomycosis from bladder cancer and the diagnosis is often made histologically.

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Section: Discussionmentioning

confidence: 84%

“…If the diagnosis is made at the time of surgery, treatment consists of 10-20 million units of intravenous penicillin, followed by a long-term oral penicillin therapy [14] . Urological procedures are necessary to differentiate actinomycosis from invasive bladder cancer or benign tumours, and the diagnosis is made pathologically [15,16] .…”

Section: Discussionmentioning

confidence: 99%

Intrauterine Device-Associated Actinomycosis of the Ovary and Urinary Bladder: A Case Report

Bottai

Marzi²,

Alessandrini³

et al. 2010

Urol Int

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“…The infl ammatory pseudotumor -also known as a pseudosarcomatous or atypical fi bromyxoid tumor is a benign mesenchymal tumor (6). The benign nature of this rare bladder tumour warrants conservative surgical management, either transurethral resection or partial cystectomy (7,8,9). The risk of recurrence of infl ammatory pseudotumors following surgical excision is low (3).…”

Section: Discussionmentioning

confidence: 99%

Inflammatory pseudotumour of urinary bladder – a rare cause of massive macroscopic haematuria

Minčík¹,

M²,

Straka³

et al. 2013

BLL

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Purpose: Authors analyzed their experience with urinary bladder tumours. This article discusses clinical and histopathological diagnostics and treatment procedures, and follow up of patients with rare benign urinary bladder tumours. Methods: 406 patients with bladder tumours were treated in our department between January 2000 and December 2008. 322 patients had superfi cial tumours and 84 had primary invasive tumours. All patients who underwent transurethral resections of these tumours were operated under general or spinal anaesthesia. The resected specimens were histologically examined in the department of Pathology. Results: 399 of the 406 patients had urothelial bladder cancer, 7 patients had a histologically uncommon type of bladder tumour, one female was diagnosed with sarcomatoid bladder cancer, one patient had a histologically confi rmed feochromocytoma of the urinary bladder. Two males had epidermoid carcinoma. One female had a histologically described uncommon benign pseudoneoplastic lesion, chararacteristic for endosalpingiosis. Another two patients were diagnosed with infl ammatory myofi broblastic tumour of the urinary bladder. Both patients presented with gross macroscopic haematuria. Authors performed complete transurethral tumour resections, which required several sessions and the deliberation of a blocked ureter through nephrostomy in one case. Conclusion: More than 98 % of all treated patients had urothelial bladder cancer in different stages and grades. Two patients had rare benign infl ammatory proliferation of the bladder wall which formed large tumorous bleeding masses obstructing the ureter in one case. These types of bladder tumour could be treated conservatively with meticulous long term follow up similarly to patients with bladder cancer (Tab. 1, Fig. 4, Ref. 15).

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Inflammatory Myofibroblastic Tumors of the Urinary Tract: A Clinicopathologic Study of 46 Cases, Including a Malignant Example Inflammatory Fibrosarcoma and a Subset Associated With High-grade Urothelial Carcinoma

Montgomery¹,

Shuster²,

Burkart³

et al. 2006

American Journal of Surgical Pathology

228

284

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Inflammatory myofibroblastic tumor (IMT) of the urinary tract, also termed postoperative spindle cell nodule, inflammatory pseudotumor, and pseudosarcomatous fibromyxoid tumor, is rare and in the past was believed to reflect diverse entities. We reviewed a series of 46 IMTs arising in the ureter, bladder, and prostate, derived primarily from a large consultation practice. There were 30 male and 16 females aged 3 to 89 years (mean 53.6). Lesions were 1.2 to 12 cm (mean 4.2). There was a history of recent prior instrumentation in 8 cases. Morphology was similar to that previously described for IMT occurring in this region, with the exception of 1 case that focally appeared sarcomatous. Polypoid cystitis coexisted in 5 patients (11%). Mitoses were typically scant (0 to 20/10 hpf, mean 1). Necrosis was seen in 14 (30%) cases. Invasion of the muscularis propria was documented in 19 (41%). By immunohistochemistry (IHC), lesions at least focally expressed anaplastic lymphoma kinase (ALK) (20/35, 57%), AE1/3 (25/34, 73%), CAM5.2 (10/15, 67%), CK18 (6/6, 100%), actin (23/25, 92%), desmin (15/19, 79%), calponin (6/7, 86%), caldesmon (4/7, 57%, rare cells), p53 (10/13, 77%), and most lacked S100 (0/14), CD34 (0/13), CD117 (2/13, 15%), CD21 (0/5), and CD23 (0/3). ALK gene alterations were detected by fluorescence in situ hybridization (FISH) in 13/18 (72%) tested cases, including 2 with prior instrumentation; 13/18 (72%) showed agreement between FISH ALK results and ALK protein results by IHC. Most bladder IMTs were managed locally, but partial cystectomy was performed as the initial management in 7 cases and cystectomy in 1 (1 IMT was initially misinterpreted as carcinoma, 1 IMT was found incidentally as a separate lesion in a cystectomy specimen performed for urothelial carcinoma). Follow-up was available in 32 cases (range 3 to 120 mo; mean 33; median 24). There were 10 patients with recurrences (2 with 2 recurrences). Recurrences were unassociated with muscle invasion or with ALK alterations. In 2 cases, tumors of the urinary tract (TURs) showing IMT preceded (1 and 2 mo, respectively) TURs showing sarcomatoid carcinoma with high-grade invasive urothelial carcinoma accompanied with separate fragments of IMT. Even on re-review the IMT in these 2 cases were morphologically indistinguishable from other cases of IMT, with FISH demonstrating ALK alterations in the IMT areas in one of them. Both these patients died of their carcinomas. Lastly, there was 1 tumor with many morphological features of IMT and an ALK rearrangement, yet overtly sarcomatous. This case arose postirradiation for prostate cancer 4 years before the development of the lesion, with tumor recurrence at 4 months and death from intra-abdominal metastatic disease at 9 months. In summary, urinary tract IMTs are rare and share many features with counterparts in other sites, displaying similar morphology and immunogenotypic features whether de novo or postinstrumentation. Typical IMTs can be locally aggressive, sometimes requiring radical surgical resection, but n...

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Myofibroblastic Inflammatory Tumors of the Bladder

Cited by 4 publications

References 3 publications

Intrauterine Device-Associated Actinomycosis of the Ovary and Urinary Bladder: A Case Report

Intrauterine Device-Associated Actinomycosis of the Ovary and Urinary Bladder: A Case Report

Inflammatory pseudotumour of urinary bladder – a rare cause of massive macroscopic haematuria

Inflammatory Myofibroblastic Tumors of the Urinary Tract: A Clinicopathologic Study of 46 Cases, Including a Malignant Example Inflammatory Fibrosarcoma and a Subset Associated With High-grade Urothelial Carcinoma

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