Partial cystectomy for a primary locally advanced leiomyosarcoma of the bladder: a case report and review of the literature

Jayarajah, Umesh; Fernando, Manoj Hilary; Herath, Kasun Bandara; Silva, Vipula Chandu de; Goonewardena, Serozsha

doi:10.1002/ccr3.1476

Cited by 5 publications

(9 citation statements)

References 17 publications

(28 reference statements)

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“…Recently, more cases of young patients with NUBC have been treated with partial cystectomy. However, they are restricted to a few case reports and series [4]. We reported our experience on partial cystectomy for NUBC which showed variable outcomes.…”

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confidence: 99%

Outcome of partial cystectomy for non-urothelial urinary bladder malignancies in a tertiary care urology unit in Sri Lanka

et al. 2021

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IntroductionNon-urothelial bladder cancers (NUBC) are very aggressive form of tumors and the standard treatment is radical cystectomy which is associated with high morbidity. This study was aimed to describe the outcome of partial cystectomy for selected patients with NUBC in a tertiary care urology unit in Sri Lanka. MethodsA retrospective analysis of all patients (n=7, males=4) who underwent partial cystectomy for NUBC in a tertiary care urology unit in National Hospital of Sri Lanka over a period of 16 years was done (From 2001(From to 2016. All underwent preliminary transurethral resection of bladder tumour (TURBT), histological confirmation and imaging before partial cystectomy. Lymphadenectomy was performed in patients with macroscopic involvement. ResultsThe median age was 59 years (range:40-71). Six patients had haematuria at presentation. Four patients had primary a d e n o c a r c i n o m a o f t h e b l a d d e r. O t h e r s w e r e leiomyosarcoma, small cell cancer and goblet cell carcinoid tumour. The majority had muscle invasive disease as confirmed by histopathology. The patients with signet ring cell carcinoma, leiomyosarcoma and well differentiated adenocarcinoma had favorable outcomes, while patients with papillary carcinoma, small cell carcinoma and goblet cell carcinoid tumour showed poor outcomes. ConclusionPartial cystectomy was associated with variable outcomes.

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Section: Discussionmentioning

confidence: 99%

Outcome of partial cystectomy for non-urothelial urinary bladder malignancies in a tertiary care urology unit in Sri Lanka

et al. 2021

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“…The proportion of non-urothelial tumours are considerably higher (8%) compared to India and Pakistan 3-4% [10,11]. Such non-urothelial bladder cancers are aggressive in nature and associated with poor survival [19][20][21]. Although the reason remains unclear, Sasikumar et al has suggested that the common use of agrochemicals and pesticides used in the semiurban and the rural community may be a possible explanation [9].…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological patterns and outcomes of urothelial bladder malignancies in Sri Lankan patients

Jayarajah¹,

Fernando²,

Herath³

et al. 2020

Ceylon Med. J.

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Introduction Studies on bladder cancer in Sri Lanka have shown varying results in relation to clinicopathological characteristics and data on outcomes is limited. This study was aimed to describe the clinicopathological characteristics and outcomes of histologically confirmed urothelial bladder malignancies and to compare with previous studies. Methods A retrospective analysis of prospectively collected data of 314 newly diagnosed primary bladder malignancies between January-2007 and January-2017, was performed. After excluding the non-urothelial cancers, 289 (92%) urothelial cancers (males=245, 84.8%, mean age = 65.4±SD10.9 years) were analysed. Data on clinical presentation, cystoscopic findings, histopathology and outcomes were studied. Results The majority (87.9%, n=254) presented with haematuria with a median duration of symptoms of 1 month. Non-muscle invasive cancers were seen among 64.4% (pTa: n=87 (30.1%), pT1: n=99 (34.3%)). The pT1 high grade (pT1-HG) tumours were seen in 17.5%. Muscle invasive bladder cancer (MIBC) were seen in 35.6% (n=103). The majority were high grade tumours (n=156, 54%). Urothelial MIBC were significantly associated with solid tumours (p<0.001), high grade (p<0.001) and size>3cm (p<0.001). Comparison with previous studies showed a decline in the proportion of MIBC while the pT1-HG tumours are on the rise. Of those followed up, 52.5% developed recurrences with a median duration of 4 months (interquartile range (IQR): 3-12 months). Eighteen (9%) progressed to a higher stage with a median duration of 17 months (IQR:3.75-41.75). Conclusions Urothelial cancer in the study population was 92%. Higher proportion of MIBC, high grade tumours and pT1-HG tumours were noted. The recurrence rate was high. Future studies should focus on the causative factors for this trend.

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“…A indicação mais comum desse procedimento é um tumor vesical músculo-invasivo (T2 ou mais) sem evidência de metástases a distância 13 . Geralmente, inclui ressecção de margens livres de invasão tumoral de cerca de dois e três centímetros e é acompanhada de radioterapia e quimioterapia adjuvantes 14 .…”

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“…A cistectomia parcial é considerada um procedimento alternativo à cistectomia radical, já que apresenta como benefício a preservação funcional da bexiga e uma menor morbidade ao paciente 14 . É geralmente indicada para pacientes jovens com tumores de pequena dimensão.…”

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“…É importante realizar um acompanhamento estrito com TC de abdome e pelve, radiografias de tórax e cistoscopia (nos casos em que o paciente realizou cistectomia parcial), especialmente no primeiro ano pós-operatório, a fim de diagnosticar precocemente recidivas tumorais e metástases à distância 7,14 . Contudo, uma das limitações deste estudo foi a impossibilidade de incluir a TC de abdome pré-operatória do paciente, por problemas internos do serviço no qual o paciente foi operado.…”

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Leiomiossarcoma De Bexiga: Um Relato De Caso

Anjos¹,

Vidotti²,

Ertel³

et al. 2021

JMRR

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Descrever caso envolvendo leiomiossarcoma (LMS) de bexiga, assunto relevante devido à baixa incidência deste tumor mesenquimal maligno. Menos de 1% dos tumores vesicais primários são LMS, e apenas 200 casos relatados na literatura, desde a primeira descrição feita há um século por Gusshaver. Métodos: A conduta terapêutica proposta foi a realização de uma cistoprostatectomia radical com reconstrução à Bricker e retossigmoidectomia. No intraoperatório, evidenciou-se extensa massa proveniente da bexiga, hipervascularizada, envolvendo a parede abdominal e comprimindo ureteres e artérias ilíacas bilateralmente, prosseguindo-se com ressecção da extensa lesão em bexiga e próstata em monobloco. O material ressecado foi encaminhado para anatomopatológico, que revelou se tratar de um sarcoma fusocelular pleomórfico de dimensões 30x25x13 cm. Na imunohistoquímica, evidenciou-se leiomiossarcoma grau I (estágio II na classificação TNM). Resultados: O paciente permaneceu internado durante 15 dias na Unidade de Terapia Intensiva (UTI) por conta de ter desenvolvido insuficiência renal crônica agudizada após a cirurgia, necessitando de diálise. Teve boa evolução no pós-operatório, apesar de manter IRC dialítica. No 22º dia de pós-operatório, se encontrava constipado, porém com Bricker funcionante e sem particularidades na ferida operatória. Conclusão: Embora a abordagem terapêutica do LMS de bexiga não seja um consenso na literatura, a modalidade pode ser justificada na situação de um tumor agressivo com prognóstico reservado.

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Partial cystectomy for a primary locally advanced leiomyosarcoma of the bladder: a case report and review of the literature

Cited by 5 publications

References 17 publications

Outcome of partial cystectomy for non-urothelial urinary bladder malignancies in a tertiary care urology unit in Sri Lanka

Outcome of partial cystectomy for non-urothelial urinary bladder malignancies in a tertiary care urology unit in Sri Lanka

Clinicopathological patterns and outcomes of urothelial bladder malignancies in Sri Lankan patients

Leiomiossarcoma De Bexiga: Um Relato De Caso

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