tailieunhanh - Báo cáo khoa học: "A case of high-grade leiomyosarcoma of the bladder with delayed onset and very poor prognosis"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: A case of high-grade leiomyosarcoma of the bladder with delayed onset and very poor prognosis | Ricciardi et al. World Journal of Surgical Oncology 2010 8 16 http content 8 1 16 WORLD JOURNAL OF SURGICAL ONCOLOGY CASE REPORT Open Access A case of high-grade leiomyosarcoma of the bladder with delayed onset and very poor prognosis Enzo Ricciardi Paolo Maniglio Mauro Schimberni and Massimo Moscarini Abstract Mesenchymal tumors represent a small number of bladder cancer cases. Leiomyosarcoma is the most common histology with over 100 cases reported in the whole literature. This tumor is been historically considered as highly aggressive and showing a poor prognosis. Despite very low survival rates showed in older reports some authors indicate that some patients could have a better outcome. We report a review of the literature and a case of high-grade LMS of the bladder in a 68 years old woman. Diagnosis was delayed and disease was locally advanced. Symptoms and imaging of our case first oriented to a gynecologic condition with an adnexal or uterine origin of the mass and a genitourinary origin could be unveiled only intra-operatively. Background Non-epithelial tumors of the urinary bladder account for less than 5 of the overall bladder malignancies with leiomyosarcoma being the of bladder cancer 1 . There are over 100 cases reported in the whole medical literature as leiomyosarcomas and a total of 192 cases considering all bladder sarcoma cases 2 . There is a lack of consensus about a standard treatment and little is known about natural history and prognosis of the tumor due to a very low incidence. Cases presented in literature had mostly gross urinary symptoms more often with an earlier onset. This may eventually lead to earlier diagnosis allowing a safer therapeutic approach. The case we report shows an unusual presentation differing from the symptoms reported in literature resembling mostly a pelvic mass. The patient underwent in the early diagnostic steps a gynecologic evaluation that addressed to a final multidisciplinary surgical approach .