Abstract：
BACKGROUND: Perivascular epithelioid cell tumor (PEComa) is a mesenchymal tumor with distinct histologic and immunologic features. PEComas that originate in the bladder are extremely rare clinically, with only 35 cases reported in the English literature thus far. Here, we report a case of bladder PEComa resection by transurethral en bloc resection of bladder tumor (ERBT).
METHODS: A 66-year-old female with a history of poorly controlled type 2 diabetes with associated complications of frequent urinary tract infections presented to our hospital for a routine physical examination. Outpatient ultrasound examination revealed a strong echogenic mass of approximately 1.5 × 1.3 × 1.3 cm in size on the posterior wall of the bladder. The enhanced computed tomography and enhanced magnetic resonance imaging after admission both suggested a well-defined isolated nodular mass on the posterior wall of the bladder with significant enhancement on the enhanced scan. The tumor was successfully and completely resected by ERBT. Postoperative pathological examination and immunohistochemical results confirmed the mass was a bladder PEComa. No tumor recurrence was observed in the six-month postoperative follow-up.
CONCLUSIONS: Bladder PEComa is an extremely rare mesenchymal tumor of the urinary system. When imaging and cystoscopy reveal a nodular mass with an abundant blood supply in the bladder, PEComa should be included in the differential diagnosis of bladder tumors. Surgical resection is currently the primary option for the treatment of bladder PEComa. For a solitary, pedunculated, narrow-based, small-sized bladder PEComa, resection of the tumor by ERBT was a safe and feasible approach in our patient and may be considered for similar cases in the future.
METHODS: A 66-year-old female with a history of poorly controlled type 2 diabetes with associated complications of frequent urinary tract infections presented to our hospital for a routine physical examination. Outpatient ultrasound examination revealed a strong echogenic mass of approximately 1.5 × 1.3 × 1.3 cm in size on the posterior wall of the bladder. The enhanced computed tomography and enhanced magnetic resonance imaging after admission both suggested a well-defined isolated nodular mass on the posterior wall of the bladder with significant enhancement on the enhanced scan. The tumor was successfully and completely resected by ERBT. Postoperative pathological examination and immunohistochemical results confirmed the mass was a bladder PEComa. No tumor recurrence was observed in the six-month postoperative follow-up.
CONCLUSIONS: Bladder PEComa is an extremely rare mesenchymal tumor of the urinary system. When imaging and cystoscopy reveal a nodular mass with an abundant blood supply in the bladder, PEComa should be included in the differential diagnosis of bladder tumors. Surgical resection is currently the primary option for the treatment of bladder PEComa. For a solitary, pedunculated, narrow-based, small-sized bladder PEComa, resection of the tumor by ERBT was a safe and feasible approach in our patient and may be considered for similar cases in the future.
摘要：
背景：血管周围上皮样细胞瘤（PEComa）是一种间充质肿瘤，具有独特的组织学和免疫学特征。起源于膀胱的PEComas在临床上极为罕见，到目前为止，英语文献中只报道了35例。这里,我们报告1例经尿道膀胱肿瘤整块切除术（ERBT）的膀胱PEComa切除术。
方法：一名66岁女性，有2型糖尿病控制不佳的病史，伴有尿路感染的并发症，到我院进行常规体检。门诊超声检查显示，膀胱后壁有强烈的回声肿块，大小约为1.5×1.3×1.3cm。入院后增强的计算机断层扫描和增强的磁共振成像均表明膀胱后壁有明确的孤立性结节，增强扫描显着增强。通过ERBT成功并完全切除了肿瘤。术后病理检查及免疫组化成果证实包块为膀胱PEComa。术后6个月随访未见肿瘤复发。
结论：膀胱PEComa是一种极为罕见的泌尿系统间充质肿瘤。当成像和膀胱镜检查显示膀胱内有大量血液供应的结节状肿块时，PEComa应包括在膀胱肿瘤的鉴别诊断中。手术切除是目前治疗膀胱PEComa的主要选择。对于一个孤独的人，有花梗，狭义的，小型膀胱PEComa，在我们的患者中,通过ERBT切除肿瘤是一种安全可行的方法,将来可能会考虑类似病例.
方法：一名66岁女性，有2型糖尿病控制不佳的病史，伴有尿路感染的并发症，到我院进行常规体检。门诊超声检查显示，膀胱后壁有强烈的回声肿块，大小约为1.5×1.3×1.3cm。入院后增强的计算机断层扫描和增强的磁共振成像均表明膀胱后壁有明确的孤立性结节，增强扫描显着增强。通过ERBT成功并完全切除了肿瘤。术后病理检查及免疫组化成果证实包块为膀胱PEComa。术后6个月随访未见肿瘤复发。
结论：膀胱PEComa是一种极为罕见的泌尿系统间充质肿瘤。当成像和膀胱镜检查显示膀胱内有大量血液供应的结节状肿块时，PEComa应包括在膀胱肿瘤的鉴别诊断中。手术切除是目前治疗膀胱PEComa的主要选择。对于一个孤独的人，有花梗，狭义的，小型膀胱PEComa，在我们的患者中,通过ERBT切除肿瘤是一种安全可行的方法,将来可能会考虑类似病例.
