Bladder leiomyosarcoma. Report of 2 cases

OBJECTIVES: The difficulties encountered in making the differential diagnosis and the highly malignant nature of leiomyosarcoma of the bladder, an uncommon tumor type, have prompted us to report on these two cases. MATERIAL AND METHODS: Two cases of leiomyosarcoma of the bladder are described: a 64-year-old female that was treated sequentially by TUR and chemotherapy and died of metastatic disease after 14 months, and an 81-year-old male with metastasis at the time of diagnosis. The literature is reviewed and the clinical pathological immunohistochemical features and treatment are discussed. CONCLUSIONS: The differential diagnosis of this tumor type is complex and requires immunohistochemical data. The diagnosis of leiomyosarcoma is confirmed by the expression of myogenic antigens. Historically, patient survival has been poor and management has been based upon information obtained from a relatively small number of cases with diverse treatment regimens. Because the efficacy of chemotherapy and radiotherapy remains unclear, the treatment of choice is by radical cystectomy or partial cystectomy when tumor location and size permit.