title: [Giant sarcomatoid carcinoma with spontaneous vesical rupture: a case report].
abstract: A 60-year-old woman has been on steroids under the diagnosis of polymyositis for 25 years. She was referred to our hospital complaining of asymptomatic macroscopic hematuria and lower abdominal pain. Physical examination revealed abdominal tenderness and rigidity. We suspected peritonitis because of free air image on the abdominal roentogenogram. The computed tomographic (CT) scan demonstrated an 8 cm solid mass in the bladder and defect of anterior wall of urinary bladder. Then we performed total cystectomy with cutaneous ureterostomy and partial resection of ileum as an emergency operation. Macroscopically, intra-peritoneal bladder rupture and severe adhesion of necrotic bladder dome wall to ileum were recognized and the tumor 8 cm in diameter existed in posterior wall of urinary bladder. Microscopic examination showed sarcomatoid carcinoma with spindle cell component and no invasion to ileum was recognized. Multiple lung, liver and bone metastasis appeared 6 months after the operation. She died of cancer 11 months after the operation.
authors.affiliation: Department of Urology, Saitama Medical Center, Saitama Medical School.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yoshinaga
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Hayashi
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Ishii
authors.forename: Rena
authors.initials: R
authors.lastname: Ohno
authors.forename: Toshiya
authors.initials: T
authors.lastname: Terao
authors.forename: Shigeyoshi
authors.initials: S
authors.lastname: Kamata
authors.forename: Toru
authors.initials: T
authors.lastname: Watanabe
authors.forename: Takumi
authors.initials: T
authors.lastname: Yamada
mesh_terms: D001859:Bone Neoplasms / Q000556:secondary; D002296:Carcinosarcoma / Q000150:complications* / Q000556:secondary / Q000601:surgery; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary; D008175:Lung Neoplasms / Q000556:secondary; D008875:Middle Aged; D012422:Rupture, Spontaneous; D014057:Tomography, X-Ray Computed; D001745:Urinary Bladder Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery