A 35-year-old woman came to the emergency department complaining of macroscopic hematuria with clots of one month duration, as well as dysuria, vesical tenesmus and abdominal pain in the hypogastrium.
Physical examination revealed pale skin and mucous membranes, hypogastric occupation and intense anemia.
Ultrasound and intravenous urography revealed a bladder filling defect compatible with bladder neoformation of 77x51x55mm, which led to bilateral calcified localiectasia.
Endoscopic examination revealed a large white solid mass of pink consistency on the left side of the bladder, with positive bimanual vaginal examination.
The pathological study of TUR-biopsy reports malignant bladder tumor of probable muscular etiology.
Computed tomography (CT) suggested a bladder tumour.
Bone screening, chest X-ray and CT did not show any distant disease.
1.
At the same time, the adriamycin (60mg/m2) and ifosfamide (5mg/m2)-based neoadjuvant therapy was administered, using magnetic resonance imaging (MRI).
At this time, a radical cystectomy was performed with a Wallace I urinary diversion.
1.
Pathological examination of the surgical specimen confirmed low grade bladder leiomyosarcoma (LMS), with immunohistochemical study positive to actin, desmin, vimentin and Ki-querc factor and negative for CD34.
The patient remains free of disease 60 months after surgery.
