title: Perivascular epithelioid cell tumour of the bladder.
abstract: A 39-year-old woman presented with a long history of pelvic pain and urinary urgency. Prior workup by her primary care doctor had been negative. The patient's gynaecologist ultimately referred her to a urologist following an ultrasound that revealed a possible bladder mass. MRI of the abdomen and pelvis demonstrated a 4 cm soft tissue lesion arising from the bladder. Cystoscopy showed an atypical mass on the anterior bladder wall, and pathological examination of the TURBT (transurethral resection of the bladder tumour) specimen revealed a perivascular epithelioid cell tumour (PEComa) with involvement of the detrusor muscle. The patient underwent a robotically assisted laparoscopic partial cystectomy. Final pathology confirmed a PEComa with negative margins. The patient had an uncomplicated postoperative course and is doing well following surgery. A surveillance cystoscopy at 6 months showed no evidence of recurrence. This case underscores the variability of clinical presentation of PEComas while proposing an appropriate method of surgical management.
authors.affiliation: Georgetown University School of Medicine, Washington, DC, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Tarplin
authors.affiliation: Department of Urology, New York Presbyterian Hospital-Weill Cornell Medical College, New York, New York, USA.
authors.forename: E Charles
authors.initials: EC
authors.lastname: Osterberg
authors.affiliation: Department of Urology, New York Presbyterian Hospital-Weill Cornell Medical College, New York, New York, USA Department of Pathology, New York Presbyterian Hospital-Weill Cornell Medical College, New York, New York, USA.
authors.forename: Brian D
authors.initials: BD
authors.lastname: Robinson
authors.affiliation: Department of Urology, New York Presbyterian Hospital-Weill Cornell Medical College, New York, New York, USA.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Herman
authors.affiliation: Department of Urology, Yale School of Medicine, New Haven, Connecticut, USA.
authors.forename: James S
authors.initials: JS
authors.lastname: Rosoff
mesh_terms: D000328:Adult; D015653:Cystectomy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D054973:Perivascular Epithelioid Cell Neoplasms / Q000175:diagnosis* / Q000601:surgery; D001743:Urinary Bladder / Q000473:pathology*; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000601:surgery