Large Rhabdomyosarcoma of the Urinary Bladder in an Adult

A 56-year-old woman presented with frequency of micturition, haematuria and cardiac decompensation. Intravenous urography showed a large bladder tumour and an expansive lesion in the left kidney. The bladder tumour, removed by TUR, was found to be a rhabdomyosarcoma, and the resected tissue weighed about 310 g. Bilateral, selective renal angiography revealed a large arteriovenous aneurysm in the right kidney and a solid malignant tumour in the left. The aneurysmal vessels were ligated and cystourethrectomy and left nephrectomy were performed 2, 3 and 10 months, respectively, after the TUR. The excised urinary bladder contained no resicual tumour. A renal cell carcinoma was found in the excised left kidney. The patient recovered well, and three and a half years after TUR of the rhabdomyosarcoma she is fully active, with normal renal function and no evidence of disease.