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Lee, Park, and Rim: Leiomyosarcoma at the Ureterovesical Junction
Case Report
Korean Journal of Urology

Korean Journal of Urology 2008; 49(9): 855-859.

Published online: 30 September 2008

DOI: https://doi.org/10.4111/kju.2008.49.9.855

Leiomyosarcoma at the Ureterovesical Junction

Jea Whan Lee, Seung Chol Park, Joung Sik Rim

Department of Urology, Wonkwang University School of Medicine, Institute of Wonkwang Medical Science, Iksan, Korea.

sc.park@wonkwang.ac.kr

Received 28 April 2008       Accepted 15 July 2008

Copyright © 2008 The Korean Urological Association

Abstract

Non-urothelial neoplasms of the bladder account for less than 5% of all bladder tumors. Leiomyosarcoma is the most common malignant mesenchymal tumor that arises in the adult bladder. Leiomyosarcomas of the bladder are considered to be highly aggressive tumors. Most patients present at an advanced stage, with less than 30% of patients presenting with stage T1 disease. Surgical resection still remains the cornerstone of treatment with the status of the surgical margin being a strong predictor of the outcome. A 59-year-old man presented to our institution with urinary urgency, and cystoscopic examination revealed a huge submucosal mass on the lateral bladder wall. A radical cystoprostatectomy and ileal neobladder procedure was performed. The patient was diagnosed with a primary leiomyosarcoma of the bladder. After 1 year of follow-up, there has been no recurrence or metastasis.

Keywords: Leiomyosarcoma, Cystectomy

Figures and Tables

Fig. 1
Cystoscopic findings. There is an intramural mass on the right lateral wall of the bladder.
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Fig. 2
Abdomino-pelvic CT scan. (A) Note the right-sided hydronephrosis with ureteral dilatation. (B) A 7×5cm low attenuation mass is seen at the right ureterovesical junction.
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Fig. 3
Pelvic T2-weighted magnetic resonance imaging (MRI). A 7×5cm subtle high signal intensity mass is seen at the right bladder base and in the ureter.
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Fig. 4
Operative findings (laparoscopic view). (A) The mass protrudes from the right bladder wall. (B) Note the mass surrounding the ureter.
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Fig. 5
(A) Gross findings: a 7×4.5cm sized whitish mass. (B) Microscopy shows the high cellularity and mild to moderate nuclear atypia (H&E, ×200).
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