Extensive rhabdomyosarcomatous differentiation in recurrent low-grade urothelial carcinoma of the bladder after transurethral resection: a case reportReportar como inadecuado




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Journal of Medical Case Reports

, 9:199

First Online: 10 September 2015Received: 26 February 2015Accepted: 20 August 2015DOI: 10.1186-s13256-015-0684-7

Cite this article as: Kamei, M., Shinohara, T., Kasahara, K. et al. J Med Case Reports 2015 9: 199. doi:10.1186-s13256-015-0684-7

Abstract

IntroductionSarcomatoid carcinoma of the urinary bladder is a rare bidirectional malignant neoplasm with epithelial and mesenchymal differentiation. The epithelial component is mainly high-grade urothelial carcinoma, and the mesenchymal component includes rhabdomyosarcoma. However, proper differential diagnosis of adult rhabdomyosarcomatous tumors of the bladder can be a challenge. Moreover, low-grade urothelial carcinoma as the epithelial component of sarcomatoid carcinoma has not been reported.

Case presentationA 64-year-old Asian man with a history of transurethral resection of low-grade urothelial carcinoma of the bladder visited our department with complaints of frequent urination and macroscopic hematuria. Computed tomography and magnetic resonance imaging demonstrated a large mass located in the anterior wall of the bladder. Pathological diagnosis of transurethral biopsy was low-grade, non-invasive papillary urothelial carcinoma, and tumor tissue was removed by total cystectomy. Immunohistochemical studies and fluorescence in situ hybridization assay of the resected neoplastic tissue revealed extensive rhabdomyosarcomatous differentiation causing the formation of a large pedunculated polyp with a papillary appearance of recurrent low-grade urothelial carcinoma. No evidence of recurrence was detected during 2 years of follow-up without further treatment.

ConclusionsUrothelial carcinoma of the urinary bladder with extensive rhabdomyosarcomatous differentiation is rare, but it should be considered in the differential diagnosis even when urothelial carcinoma coexisting with a rhabdomyosarcomatous component is low-grade and non-invasive.

KeywordsSarcomatoid carcinoma Urothelial carcinoma Rhabdomyosarcomatous differentiation Transurethral resection Anaplastic lymphoma kinase AbbreviationsALKAnaplastic lymphoma kinase

CTComputed tomography

FISHFluorescence in situ hybridization

IMTInflammatory myofibroblastic tumor

LOHLoss of heterozygosity

MRIMagnetic resonance imaging

RMSRhabdomyosarcoma

SCSarcomatoid carcinoma

TCCTransitional cell carcinoma

TURTransurethral resection

UCUrothelial carcinoma

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Autor: Maiko Kamei - Tsutomu Shinohara - Kotaro Kasahara - Takahira Kuno - Keishi Naruse - Hironobu Watanabe

Fuente: https://link.springer.com/



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