Low-grade leiomyosarcoma of the bladder: a case report and literature review

doi:10.3877/cma.j.issn.1674-3253.2026.02.016

Abstract

Abstract:

Objective

To report a case of low-grade leiomyosarcoma of the bladder, summarize the clinical diagnosis and treatment process and review relevant literature, then discuss the diagnosis and treatment of bladder leiomyosarcoma to improve the understanding of this disease.

Methods

A 35-year-old male patient with low- grade leiomyosarcoma of bladder admitted to Third Affiliated Hospital of Southern Medical University was analyzed retrospectively. He presented with " urinary frequency, urgency, and dysuria for more than one week". The imaging examinations and cystoscopic tumor biopsy were performed, and the pathological diagnosis was low-gradeleiomyosarcoma of the bladder.

Results

After comprehensive consideration, the patient underwent partial cystectomy. Postoperative pathology confirmed low-grade leiomyosarcoma of the bladder. Immunohistochemistry showed that SMA(+), Desmin(+), IMP3 was strongly positive, and the incision margin was negative. The patient was discharged without urine leakage. After two-year follow-up, the patient showed no tumor recurrence.

Conclusions

Leiomyosarcoma of the bladder is a rare malignant tumor with highly invasive and poor prognosis generally. The primary treatment is surgery. Radical resection is the main treatment for high-grade leiomyosarcoma of the bladder, followed by radiotherapy and chemotherapy. Partial cystectomy is feasible for low-grade and small tumors. During surgery, it is crucial to obtain a negative surgical margin of at least 2-3 cm around the tumor.

Key words: Bladder tumor, Leiomyosarcoma, Partial cystectomy

Kang He, Cheng Yang, Jianxiong Li, Ming Xia, Mingkun Chen, Cundong Liu, Hui Xia. Low-grade leiomyosarcoma of the bladder: a case report and literature review[J]. Chinese Journal of Endourology(Electronic Edition), 2026, 20(02): 221-225.

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References 18

[1]	Rodríguez D, Preston MA, Barrisford GW, et al. Clinical features of leiomyosarcoma of the urinary bladder: analysis of 183 cases[J]. Urol Oncol, 2014, 32(7): 958-965. DOI: 10.1016/j.urolonc.2014.01.025.
[2]	Ramírez Sevilla C, Admella-Salvador C, Romero-Martin JA, et al. Bladder leiomyosarcoma 25 years after treatment with cyclophosphamide in patient with history of retinoblastoma[J]. Urol Int, 2018, 100(1): 119-121. DOI: 10.1159/000437442.
[3]	谭智勇, 李宁, 黄应龙, 等. 误诊为尿路上皮癌的膀胱平滑肌肉瘤1例并文献分析[J]. 国际泌尿系统杂志, 2020, 40(2): 321-323. DOI: 10.3760/cma.j.issn.1673-4416.2020.02.035.
[4]	Uhlman MA, Gibbons EP, Gasana A, et al. A 26-year old female with leiomyosarcoma of the bladder and a serendipitous cystectomy-a success story from international volunteers in Urology[J]. Urol Case Rep, 2018, 21: 17-18. DOI: 10.1016/j.eucr.2018.08.006.
[5]	Ohan H, Minassian G, Minassian H, et al. Retinoblastoma in infancy with subsequent bladder leiomyosarcoma in adulthood: genomic considerations[J]. Urology, 2020, 140: 38-40. DOI: 10.1016/j.urology.2020.03.010.
[6]	Zieschang H, Koch R, Wirth MP, et al. Leiomyosarcoma of the urinary bladder in adult patients: a systematic review of the literature and meta-analysis[J]. Urol Int, 2019, 102(1): 96-101. DOI: 10.1159/000494357.
[7]	谭智勇, 李宁, 王海峰, 等. 微创治疗膀胱平滑肌肉瘤1例报告[J]. 现代泌尿外科杂志, 2019, 24(11): 970-971. DOI: 10.3969/j.issn.1009-8291.2019.11.022.
[8]	罗晓青, 杨光华, 郭立新, 等. 48例软组织平滑肌肉瘤的病理及免疫组化研究[J]. 临床与实验病理学杂志, 2000, 16(1): 11-14. DOI: 10.3969/j.issn.1001-7399.2000.01.006.
[9]	Lindberg MR, Fisher C, Thway K, et al. Leiomyosarcoma of the urinary bladder: a clinicopathological study of 34 cases[J]. J Clin Pathol, 2010, 63(8): 708-713. DOI: 10.1136/jcp.2010.077883.
[10]	Xiao X, Hu R, Deng FM, et al. Practical applications of immunohistochemistry in the diagnosis of genitourinary tumors[J]. Arch Pathol Lab Med, 2017, 141(9): 1181-1194. DOI: 10.5858/arpa.2016-0530-RA.
[11]	Ribeiro JGA, Klojda CAB, Araújo CP, et al. Giant leiomyosarcoma of the urinary bladder[J]. J Clin Diagn Res, 2016, 10(5): PD14-PD15. DOI: 10.7860/JCDR/2016/18971.7858.
[12]	Coiner BL, Cates J, Kamanda S, et al. Leiomyosarcoma of the urinary bladder: a SEER database study and comparison to leiomyosarcomas of the uterus and extremities/trunk[J]. Ann Diagn Pathol, 2021, 53: 151743. DOI: 10.1016/j.anndiagpath.2021.151743.
[13]	Rosser CJ, Slaton JW, Izawa JI, et al. Clinical presentation and outcome of high-grade urinary bladder leiomyosarcoma in adults[J]. Urology, 2003, 61(6): 1151-1155. DOI: 10.1016/s0090-4295(03)00021-9.
[14]	刘宇, 文春森, 张龙, 等. 成人膀胱平滑肌肉瘤17例诊治分析[J]. 现代泌尿外科杂志, 2022, 27(6): 499-502. DOI: 10.3969/j.issn.1009-8291.2022.06.011.
[15]	Spiess PE, Kassouf W, Steinberg JR, et al. Review of the M.D. Anderson experience in the treatment of bladder sarcoma[J]. Urol Oncol, 2007, 25(1): 38-45. DOI: 10.1016/j.urolonc.2006.02.003.
[16]	郑铎, 刘隽垚, 齐鹏, 等. 膀胱平滑肌肉瘤一例报告[J]. 中华泌尿外科杂志, 2018, 39(2): 151. DOI: 10.3760/cma.j.issn.1000-6702.2018.02.022.
[17]	Matsumoto S, Shimizu N, Moriguchi N, et al. Bladder leiomyosarcoma in a boy[J]. Int Urol Nephrol, 2006, 38(3-4): 549-551. DOI: 10.1007/s11255-006-0072-8.
[18]	Delgado-Prada A, Borrás J, Farzanegan R, et al. Cutaneous reaction to ifosfamide plus mesna treated with desensitization challenge: a case report[J]. Clin Mol Allergy, 2022, 20(1): 7. DOI: 10.1186/s12948-022-00173-0.

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