title: Urinary bladder leiomyosarcoma in adults.
abstract: BACKGROUND
  Non-urothelial neoplasms of the bladder account for fewer than 5% of all bladder tumors. Sarcoma constitutes the most usual mesenchymal malignancy of the bladder, with leiomyosarcomas being the most common type of sarcoma in adults.
  
  
  METHODS
  The records of seven patients presenting to two different institutions with bladder leiomyosarcomas between 2003 and 2007 and between 2000 and 2007, respectively, were examined. Cystoscopy, with transurethral resection of the bladder tumor was initially performed in all patients, with leiomyosarcoma being initially diagnosed on the basis of examination of the transurethral specimen.
  
  
  RESULTS
  There were N = 5 men and N = 2 women with a median age of 64.8 years at presentation. All seven patients underwent a definitive surgical procedure. Complete resection with negative surgical margins was achieved in all seven patients (100%). MSKCC stage included 86% of patients with stage 3 (N = 6) and 14% with stage 2 (N = 1). A low-grade tumor was evident in one patient only, with the remaining 86% exhibiting a high-grade tumor.
  
  
  CONCLUSIONS
  Leiomyosarcomas of the bladder have always been considered as a highly aggressive entity and little is known about their origin, clinicopathologic presentation, and the survival factors associated with them. Contemporary studies suggest that these tumors may have a better prognosis than once believed. Leiomyosarcomas require aggressive surgical extirpation and, when surgical resection is possible, radical cystectomy with wide margins is the rule and should be performed. Strict adherence to standard surgical technique has resulted in low rates of positive surgical margins and low rates of local tumor recurrence.
authors.affiliation: Department of Urology, Martha Maria Medical Center, Stadenstrasse 58, 90409 Nurnberg, Germany. Labanaris@web.de
authors.forename: Apostolos P
authors.initials: AP
authors.lastname: Labanaris
authors.forename: Vahudin
authors.initials: V
authors.lastname: Zugor
authors.forename: Bernd
authors.initials: B
authors.lastname: Meyer
authors.forename: Reinhold
authors.initials: R
authors.lastname: Nützel
authors.forename: Stephan
authors.initials: S
authors.lastname: Helmus
authors.forename: Panagiotis G
authors.initials: PG
authors.lastname: Labanaris
authors.forename: Reinhard
authors.initials: R
authors.lastname: Kühn
mesh_terms: D000368:Aged; D017024:Chemotherapy, Adjuvant; D015653:Cystectomy; D005260:Female; D006801:Humans; D007890:Leiomyosarcoma / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery*; D014547:Urinary Diversion