病例報告-膀胱横纹肌惡性腫瘤
林永健
馬來西亞 亞羅士打 仁愛專科醫藥中心 泌尿外科
Case report- Bladder Rhabdomyosarcoma
Eng-Kian Lim
Division of Urology, Putra Medical Centre, Alor Setar, Malaysia
Purpose: We reported a case of male bladder Rhabdomyosarcoma whom received surgical intervention in our hospital.
Case Presentation: A 78 year old male of bladder tumor was noted and treated in our hospital during 4th to 5th Nov, 2015.This 78 year old male patient came to our urology outpatient department with chief complaints of gross hematuria for few days. Lab data showed: mild anemia, hyponatremia, hyperglycemia (Hb: 11.5, Na: 131, Sugar: 25.4) with normal Creatinine (Cr: 91). Abdomen sonography revealed: huge bladder tumor lesion. He was admitted for cystoscopy and received TURBT on 4th, Nov under spinal anesthesia without consequence. Meanwhile OHA (Metformin) was given for DM control. Pathology revealed: Bladder Rhabdomyosarcoma. Post operation abdomen and pelvic CT scan was done with no distant metastasis. He was then referred to government tertiary hospital oncology department for further management.
Conclusion: Rhabdomyosarcoma is a malignant tumor (cancer) that arises from a normal skeletal muscle cell. Rhabdomyosarcoma represents the most common malignant soft tissue tumor in children and adolescents with the urinary bladder representing a frequent site. Most of these are embryonal Rhabdomyosarcoma, predominantly the botryoid subtype. Rhabdomyosarcoma of bladder in adults are distinctively rare and only case reports was noted. 1 The most common metastasis site are lung, bones and bone marrow. Complete tumor excision should be considered for localized adults cases as long as functional and cosmetic results are acceptable. Radiotherapy is also a major tool for treatment, particularly achieving local control in patients with residual microscopic or gross disease following surgery and chemotherapy. 2
References:
1. Paner GP, McKenney JK, Epstein JI, Amin MB. Rhabdomyosarcoma of the urinary bladder in adults: predilection for alveolar morphology with anaplasia and significant morphologic overlap with small cell carcinoma. Am J Surg Patho. 2008 Jul: 32(7): 1022-8.
2. Kelven Weijing Chen, Fiona Mei Wen Wu, Victor Kwan Min Lee, Kesavan Esuvaranathan. Embryonal Rhabdomyosarcoma of the Adult Urinary Bladder: A Rare Case Report of Misclassifications as inflammatory Myofibroblastic Tumor. Case Rep Surg. 2015; 2015: 510508.