title: Spindle cell cancer of bladder during cyclophosphamide therapy for Wegener's granulomatosis.
abstract: A 38-year-old woman with long-standing Wegener's granulomatosis had remission with cyclophosphamide therapy after failure of response to other agents. Severe cystitis with massive blood loss necessitated a cystectomy. The bladder contained an unsuspected neoplasm, histologically resembling leiomyosarcoma, but desmosomes seen on electron-microscopic examination suggested that this was a spindle cell carcinoma. The findings document occurrence of cyclophosphamide related bladder cancer in a patient without a previously diagnosed neoplasm and indicate a need for cytologic monitoring of the bladder in patients requiring therapy with this drug.
mesh_terms: D000328:Adult; D002277:Carcinoma / Q000139:chemically induced* / Q000473:pathology / Q000648:ultrastructure; D003520:Cyclophosphamide / Q000009:adverse effects* / Q000627:therapeutic use; D003896:Desmosomes / Q000648:ultrastructure; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000188:drug therapy*; D006801:Humans; D007890:Leiomyosarcoma / Q000473:pathology; D008854:Microscopy, Electron; D001749:Urinary Bladder Neoplasms / Q000139:chemically induced* / Q000473:pathology / Q000648:ultrastructure
chemical_list: D003520:Cyclophosphamide