Rodríguez-Cambranis S, Suárez-López MR, Ordóñez-Escalante K, Méndez-Domínguez N

Language: Spanish
References: 11
Page: 233-236
PDF size: 377.50 Kb.

ABSTRACT

Introduction: Bladder leiomyosarcomas are very low-incidence tumors, diagnosis and, therefore, treatment are challenging and could derive in delayed approach on detriment of the patient’s prognosis. Objective: To describe the clinical picture, management and diagnostic challenges in a case of urinary bladder leiomyosarcoma, to provide useful information that could be correlated with clinical practice to guide the diagnosis and optimal therapeutic approach. Case report: A 65-year-old female presented with macroscopic hematuria, pelvic pain and palpable mass in the pelvic region. The therapeutic behavior was extra fascial hysterectomy surgery. Biopsy showed a connective fiber tumor unspecific light inflammatory reaction was reported, without ruling out neoplasia. Discussion: Bladder cancer usually occurs in the covering mucosa found throughout the urinary system and urothelium, since leiomyosarcoma is a very low incidence type of cancer. The approach is very nonspecific and there is no guide to the diagnosis and treatment protocol. Conclusions: In the presented case, the presence of a leiomyosarcoma was not included among the initial differential diagnoses, but its correct identification could lead to an adequate management for this type of neoplasms. It is important to include leiomyosarcomas between differential diagnoses in patients who present a clinical picture compatible with the one presented here.

REFERENCES

1. Herrera-Gómez A, Granados-García M, González-Barón M. Manual de oncología. Procedimientos médicos quirúrgicos. 3a ed. México: McGraw Hill; 2006.

2. Cumplido-Burón JD, Toral-Peña JC. Leiomiosarcoma de vejiga: cistectomía parcial y tratamiento complementario. Arch Esp Urol. 2009; 62 (4): 320-322.

3. Delgado NS, Manero JB, Ariño AB, Prats MG, Vélez JS. Leiomiosarcoma de vejiga urinaria. Actas Urol Esp. 2001; 25 (5): 385-387.

4. Cruz-Guerra NA, Fradejas-Rodríguez A, Valle-Manteca AD, Ursúa-Sarmiento I, Tarroc-Blanco A. Leiomiosarcoma vesical: aportación de un nuevo caso. Arch Esp Urol. 2006; 59 (2): 198-201.

5. Rioja J, Rosell-Costa D, Rincón-Mayans A, Saiz-Sansi A, Panizo-Santos A, Berián-Polo JM. Leiomiosarcoma vesical: Presentación de un nuevo caso y revisión de la literatura. Actas Urol Esp. 2009; 33 (7): 816-821.

6. National Center for Biotechnology Information, U.S. National Library of Medicine. [Consulta el: 20/03/18] Disponible en: https://www.ncbi.nlm.nih.gov/mesh/68007890

7. Zhou M, Netto GJ, Epstein JI. Uropathology. Elsevier Health Sciences; 2012.

8. Correa JJ, Martínez CA, Gaviria A, Hessen MR, Jaramillo JL, Osorio HD et al. Carcinosarcoma de vejiga, una patología poco frecuente: reporte de dos casos. Revista Urología Colombiana [en línea]. 2012 [Fecha de consulta: 3 de mayo de 2018] Disponible en: http://www.redalyc.org/html/1491/149125110007/

9. Martin SA, Sears DL, Sebo TJ, Lohse CM, Cheville JC. Smooth muscle neoplasms of the urinary bladder: a clinicopathologic comparison of leiomyoma and leiomyosarcoma. Am J Surg Pathol. 2002; 26 (3): 292-300.

10. Ricciardi E, Maniglio P, Schimberni M, Moscarini M. A case of high-grade leiomyosarcoma of the bladder with delayed onset and very poor prognosis. World J Surg Oncol. 2010; 8 (1): 16.

11. Hamadalla NY, Rifat UN, Safi KC, Mohammed M, Abu-Farsakh H. Leiomyosarcoma of the urinary bladder: A review and a report of two further cases. Arab J Urol. 2013; 11 (2): 159-164.