PDF(Pubmed)
Abstract：
Carcinosarcoma or sarcomatoid carcinoma of the urinary bladder is a rare but aggressive bladder cancer characterized by malignant epithelial and mesenchymal components, with only a few cases reported in the literature so far. In this report, we discuss a case of a 74-year-old female nonsmoker who presented with intermittent hematuria and passage of clots in the last four months. Radiographic images showed an irregular mass lesion (6.2 x 6 cm) in the left lateral wall of the urinary bladder near to left vesicoureteral junction. The mass was completely removed with transurethral resection of the bladder tumor (TUR-BT). Histopathological study revealed high-grade carcinosarcoma, and immunohistochemistry showed diffuse positivity for vimentin, pan-cytokeratin (CK) and CK7, epithelial membrane antigen (EMA), and CK5/6. The patient declined radical cystectomy and only agreed to receive intravesical chemotherapy (gemcitabine), and she remains alive after more than four years of follow-up. Carcinosarcoma of the urinary bladder is a rare tumor primarily affecting older people, and it is most commonly treated with radical cystectomy and different combination treatments such as chemotherapy and radiation. However, tumor resection followed by intravesical chemotherapy may be an alternative option in the early stages of bladder carcinosarcoma for some patients, thereby avoiding the need for aggressive treatments, especially for elderly patients who decline to undergo radical surgery.
摘要：
膀胱癌肉瘤或肉瘤样癌是一种罕见但侵袭性的膀胱癌，其特征是恶性上皮和间质成分。到目前为止，文献中只报道了少数病例。在这份报告中,我们讨论了一例74岁女性非吸烟者,该患者在过去4个月内出现间歇性血尿和血块通过.X线图像显示膀胱左侧壁靠近膀胱输尿管连接处的不规则肿块（6.2x6cm）。通过经尿道膀胱肿瘤切除术（TUR-BT）将肿块完全切除。组织病理学研究显示高级别癌肉瘤，免疫组织化学显示波形蛋白弥漫性阳性，泛细胞角蛋白（CK）和CK7，上皮膜抗原（EMA），CK5/6患者拒绝根治性膀胱切除术，只同意接受膀胱内化疗（吉西他滨），经过四年多的随访，她仍然活着。膀胱癌肉瘤是一种罕见的肿瘤，主要影响老年人，最常见的是根治性膀胱切除术和不同的联合治疗方法，如化疗和放疗。然而,肿瘤切除后膀胱灌注化疗可能是一些患者早期膀胱癌肉瘤的替代选择，从而避免了积极治疗的需要，特别是对于拒绝接受根治性手术的老年患者。
