Sarcomatoid carcinoma of the urinary bladder with heterologous osteosarcomatous differentiation
Authors:
Karol Kajo 1; Vladimír Baláž 2; Katarína Macháleková 1,3; Peter Čunderlík 1; Milan Švec 2; Jozef Babeľa 2
Authors‘ workplace:
BB BIOCYT diagnostické centrum s. r. o.
Banská Bystrica
1; II. urologická klinika SZU vo FNsP F. D.
Roosevelta, Banská Bystrica
2; Oddelenie patológie, Onkologický ústav
sv. Alžbety s. r. o., Bratislava
3
Published in:
Ces Urol 2011; 15(2): 120-125
Category:
Case report
Overview
To point at morphological and clinical features of the rare sarcomatoid carcinoma (SC) with heterologous osteosarcomatous differentiation occurred in the urinary bladder.
This is a case of a 78-year-old man with massive macroscopic hematuria and a tumour in the urinary bladder sized 50 × 45 mm, confirmed by ultrasonography and computer tomography, without any signs of dissemination to distant sites. In the material obtained from transurethral resection there was histologically proved malignant biphasic tumour with components of the high-grade carcinomatous (urothelial) and mesenchymal (osteosarcomatous) type. Immunohistochemical analysis showed positive staining of the epithelial markers in carcinomatous component (cytokeratins, epithelial membrane antigen), which was not proved in the sarcomatous part of the tumour. According to polymorbidity of the patient planned radical surgical therapy was stopped and patient underwent combined radiotherapy and chemotherapy.
SC with heterologous osteosarcomatous differentiation is very rare neoplasm in the urinary bladder, which is characterized by rapid growth and aggressive behaviour, therefore it is very important to include it into diagnostic considerations.
Key words:
carcinosarcoma, osteosarcoma, urinary bladder, sarcomatoid carcinoma.
Sources
1. Eble JN, Santer G, Epstein JI, Sesterhenn IA. World Health Organization Classification of Tumours: Pathology and Genetics of Tumours of the Urinary System and Male Genital Organs. Lyon: IARC Press 2004; 359.
2. Arenas LF, Fontes DA, Pereira EM, Hering FL. Sarcomatoid carcinoma with osseous differentiation in the bladder. Int Braz J Urol 2006; 32: 563–565.
3. Torenbeek R, Blomjous CM, de Bruin PC, Newling DWW, Meiler CJLM. Sarcomatoid carcinoma of the urinary bladder. Am J Surg Pathol 1994; 18: 241–249.
4. Lopez-Beltran A, Pacelli A, Rothenberg HJ, et al. Carcinosarcoma and sarcomatoid carcinoma of the bladder: clinicopathological study of 41 cases. J Urol 1998; 159: 1497–1503.
5. Sigal SH, Tomaszewski JE, Brooks JJ, Wein A, LiVolsi VA. Carcinosarcoma of bladder following long-term cyclophosphamide therapy. Arch Path Lab Med. 1991; 115: 1049–1051.
6. Maestroni U, Giollo A, Barbieri A, et al. Bladder carcinosarcoma: a case observation. Acta Bio Medica Ateneo Parmense 2004; 75: 74–76.
7. Perret L, Chaubert P, Hessler D, Guillou L. Primary heterologous carcinosarcoma (metaplastic carcinoma) of the urinary bladder. A clinicopathologic, immunohistochemical, and ultrastructural analysis of eight cases and a review of the literature. Cancer 1998; 82: 1535–1549.
8. Baschinsky DY, Chen JH, Vadmal MS, et al. Carcinosarcoma of the urinary bladder – an agressive tumor with diverse histogenesis. A clinicopathologic study of 4 cases and review of the literature. Arch Pathol Lab Med 2000; 124: 1172–1178.
9. Atsuko F, Yasunori K, Kazuya M, Mutsumi U. Sarcomatoid carcinoma of the urinary bladder with a spontaneous perforation: a case report. Acta Urol Jpn 2002; 48: 607–610.
10. Naiki T, Kawai N, Nagata D, Andoh Y, Kamisawa H, Katoh T, Akita H, Okamura T. Carcinosarcoma of the urinary bladder with rapid growth: a case report. J Rural Med 2009; 4: 27–31.
11. DeWever O, Pauwels P, CeCraene B, et al. Molecular and pathological signatures of epithelialmesenchymal transitions at the cancer invasion front. Histochem Cell Biol 2008; 130: 481–494.
12. Froehner M, Gaertner HJ, Manseck A, Wirth MP. Durable complete remission of metastatic sarcomatoid carcinoma of the bladder with cisplatin and gemcitabine in an 80-year-old man. Urology 2001; 58: 799.
13. Wang J, Wang FW, LaGrange CA, Henstreet GP, Kessinger A. Clinical features of sarcomatoid carcinoma (carcinosarcoma of the urinary bladder: analysis of 221 cases. Sarcoma 2010; article ID 454792, doi:10.1155/2010/454792.
Labels
Paediatric urologist Nephrology UrologyArticle was published in
Czech Urology
2011 Issue 2
Most read in this issue
- Lichen sclerosus – commonly overlooked urological diagnosis with serious complications
- Neural control of the lower urinary tract
- Impalpable testis, what first: diagnostic laparoscopy or inguinal exploration?
- Carbonic anhydrase IX (CA IX) expression in renal cell carcinoma and transitional cell carcinoma of urinary tract