罕見的膀胱外的膀胱腫瘤－耕莘醫院經驗
古哲維、姜秉均、廖俊厚
耕莘醫院 外科部 泌尿科
A unusual cases report of urinary bladder tumor - cardinal tien hospital experience
Che-Wei Ku, Bing-Juin Chiang, Chun-Hou, Liao
Divisions of Urology, Department of Surgery, Cardinal Tien Hospital, New Taipei City, Taiwan
Introduction: Bladder neoplasms can arise from any of the bladder layers and most bladder tumors are derived from the urothelium. We report one female patient with bladder tumor other than urothelial carcinoma and negative cystoscopy.
Case Report: This 34-year-old woman is a patient without systemic disease. She had experiencing painless hematuria for 1 day and visited obstetrics and gynecology. Bimanual vaginal (PV) examination showed smooth cervix and vagina, there is no mass made out over uterus and adnexa. Pelvic sonography showed a small myoma and a complex mass close to bladder. Then, she was referred to urology outpatient department for consultation. Urinalysis showed no hematuria and pyuria. Cystoscopy showed no any tumor in bladder cavity. Pelvic MRI showed a 3cm retroperitoneal mass. Then, she received exploratory laparotomy, bladder tumor excision with partial bladder wall resection. The specimen submitted consisted of a piece of soft tissue form bladder wall, measuring 4 x 2.3 x 2 cm in size. The report of surgical pathology is bladder leiomyoma.
Discussion: There are with less 4% being non-epithelial or mesenchymal tumor. Leiomyoma is the most common mesenchymal tumor of the bladder but accounts for only 0.43% of bladder tumors. Leiomyomas occur equally in men and women with a wide age range of 22-78 years and with no malignant potential. Since the symptoms of leiomyoma of the urinary bladder may mimic urothelial carcinoma lesions, they should always be considered in the differential diagnosis of genitourinary mass.