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CASE REPORT |
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Year : 2006 | Volume
: 22
| Issue : 3 | Page : 266-267 |
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Sarcomatoid carcinoma of the bladder after ileocystoplasty
AW Shindel1, EJ Traxel1, TL Bullock1, S Gibson2
1 Department of Surgery, Division of Urology, Washington University Medical Center, Campus Box 8242, 4960 Children's Place, Saint Louis, USA 2 Department of Pathology, John Cochran Veteran's Administration Medical Center, 915 North Grand Blvd, Saint Louis, USA
Correspondence Address: A W Shindel 4960 Children's Place Campus, Box 8242 Saint Louis USA
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0970-1591.27639
Keywords: Cancer, ileocystoplasty, sarcomatoid carcinoma
How to cite this article: Shindel A W, Traxel E J, Bullock T L, Gibson S. Sarcomatoid carcinoma of the bladder after ileocystoplasty. Indian J Urol 2006;22:266-7 |
Case Report | |  |
A 58-year-old man presented for evaluation of hematuria. He was 20 years status-post ileocystoplasty for a small capacity, poorly compliant bladder at an outside institution. CT scan was obtained which demonstrated a large mass completely filling the bladder as well as hypodense liver lesions. The lesion was initially thought to represent a concretion of mucus. To further evaluate the lesion a CT scan with intravenous contrast was obtained. After administration of IV contrast, the bladder mass and liver lesions were found to enhance [Figure - 1]. A CT-guided biopsy of the liver was performed. Tissue staining of the biopsy with hematoxylin and eosin was revealing of sarcomatoid carcinoma [Figure - 2]. Staining with pankeratin [Figure - 3] and vimentin [Figure - 4] confirmed that both carcinomatous and sarcomatous elements were present in the biopsy specimen.
The patient underwent palliative radiation therapy and percutaneous nephrostomy tube placement. He succumbed to disease five months after his initial presentation.
Sarcomatoid carcinoma of the bladder is a rare but aggressive malignancy with a very poor prognosis. To our knowledge sarcomatoid carcinoma in an augmented bladder has not previously been reported. Adenocarcinoma is the most common malignant tumor found in augmented bladders.[1] Squamous cell carcinoma,[1] transitional cell carcinoma,[1] signet ring cell carcinoma,[2] small cell carcinoma,[3] undifferentiated sarcoma[4] and nephrogenic adenomas[5] have been reported to occur in augmented bladders.
References | |  |
1. | Woolsey S, Nambirajan T, Mahendra V, Mulholland C, Kernohan R. Squamous cell carcinoma and transitional cell carcinoma arising in bladder augmentations. Scand J Urol Nephrol. 2003;37:269-70. [PUBMED] |
2. | Fernandez-Arjona M, Herrero L, Romero JC, Nieto S, Martin R, Pereira I. Synchronous signet ring cell carcinoma and squamous cell carcinoma arising in an augmented ileocystoplasty. Case report and review of the literature. Eur Urol 1996;29:125-8. [PUBMED] |
3. | Golomb J, Lewin KJ, deKernion JB, Raz S. Primary small cell carcinoma of the augmented urinary bladder. Br J Urol 1992;70:572-3. [PUBMED] |
4. | Egbert BM, Kraft JK, Perkash I. Undifferentiated sarcoma arising in an augmented ileocystoplasty patch. J Urol 1980;123:272-4. [PUBMED] |
5. | Goldman HB, Dmochowski RR, Noe HN. Nephrogenic adenoma occurring in an augmented bladder. J Urol 1996;155:1410. [PUBMED] |
[Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4]
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