We report the case of a 64-year-old female patient with no relevant urological history, who complained of hematuria for four months with associated urgency urinary incontinence, and who was detected during routine gynecologic examination with bladder voiding.
Physical examination only revealed hypogastric discomfort with bimanual abdominovaginal pathology, as well as doubtful concomitant mass effect.
The basic analytical parameters were within normal limits.
Intravenous urography showed a filling defect with the ultrasonographic location of the newly described malformation.
Subsequently, a cystoscopy was performed, which showed the existence of a mixed lesion, with solid and papillary areas, predominantly located in the anterior wall and bladder dome.
Transurethral resection of the neoformation was indicated.
The result of the anatomopathological and immunohistochemical study - positivity for actin, desmin and vimentin - was compatible with leiomyosarcoma.
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The extension study - computerized axial tomography and bone scintigraphy - allowed ruling out the existence of regional or distant involvement, for which we proceeded to practice anterior pelvic exantheration and cutaneous anastomosis.
The histological study of the cystectomy specimen showed the presence of intense chronic inflammatory changes in the bladder, large tissue and multilayered giant cells, with absence of nucleotage chain, lymph0 and without involvement.
After one year of follow-up, recurrence was not observed.
