案例報告:罕見良性膀胱肌瘤

王嘉源、張東平、薛又仁、黃建榮、賴昱維、蕭毅君、李淑文、陳修聖、邱文祥、高國維

台北市立聯合醫院仁愛院區 外科部 泌尿科

A case report: Clinical insights from four rare cases of bladder leiomyoma

Chia-Yuan Wang, Tung-Ping Chang, Thomas Y. Hsueh, Andy C. Huang, Yu-Wei Lai, Yi-Chun Hsiao, Shu-Wen Li, Shiou-Sheng Chen, Allen W. Chiu, Kuo-Wei Kao

Divisions of Urology, Department of Surgery, Taipei City Hospital Renai branch

Purpose: Leiomyoma is the most common benign mesenchymal tumor in bladder, though it accounts for less than 0.5% of all bladder tumors, with only about 250 cases reported in the literature. Most patients present with irritative or obstructive voiding symptoms, and prognosis is generally favorable with a low recurrence rate. The aim of this case series is to present the clinical features, imaging characteristics, and treatment outcomes of four cases of bladder leiomyoma and compare our findings with previous studies.

Results: There are four cases were collected. Three patients presented with abdominal or hip pain, while one had painless gross hematuria. Radiological assessments including ultrasonography, computed tomography(CT) or magnetic resonance imaging(MRI). The pathology report revealed positive desmin and SMA, confirming the diagnosis of bladder leiomyoma. Three patients underwent transurethral resection of the bladder tumor (TURBT), while one underwent laparoscopic enucleation. Two of the patient who underwent TURBT had tumor recurrence at 10^th and 2^nd year.

Conclusions: These cases underscore the rare presentation of bladder leiomyoma and highlight the characteristic of radiological imaging and cystoscopic features. Given its benign nature and low recurrence rate, accurate identification of this tumor is essential. Our findings suggest that patients who undergo conventional or laparoscopic transvesical resection may experience lower recurrence rates compared to those treated with TURBT, supporting transvesical resection as a potentially preferable treatment option for bladder leiomyoma.