Embryonal rhabdomyosarcoma of the adult urinary bladder: a rare case report of misclassification as inflammatory myofibroblastic tumor.
Embryonal rhabdomyosarcoma (ERMS) of the adult urinary bladder is a rare malignant tumour. Inflammatory myofibroblastic tumour (IMT) of the bladder is a benign genitourinary tumour that may appear variable histologically but usually lacks unequivocal malignant traits. Techniques like flow cytometry and immunohistochemistry may be used to differentiate these two tumours. Our patient, a 46-year-old male, had rapidly recurring lower urinary tract symptoms after two transurethral resections of the prostate. He subsequently underwent a transvesical prostatectomy which showed IMT on histology. However, his symptoms did not resolve and an open resection done at our institution revealed a 6 cm tumour arising from the right bladder neck. This time, histology was ERMS with diffuse anaplasia of the bladder. Rapid recurrence of urinary symptoms with prostate regrowth after surgery is unusual. Differential diagnoses of uncommon bladder malignancies should be considered if there is an inconsistent clinical course as treatment approaches are different.
Department of Urology, National University Health System, 1E Kent Ridge Road, Singapore 119228.
Kelven Weijing
KW
Chen
Department of Urology, National University Health System, 1E Kent Ridge Road, Singapore 119228.
Fiona Mei Wen
FM
Wu
Department of Pathology, National University Health System, 1E Kent Ridge Road, Singapore 119228.
Victor Kwan Min
VK
Lee
Department of Urology, National University Health System, 1E Kent Ridge Road, Singapore 119228.
Kesavan
K
Esuvaranathan