An Asymptomatic Intramural Leiomyoma of Bladder in Male Patient

Case Report

Austin J Urol. 2014;1(2): 3.

An Asymptomatic Intramural Leiomyoma of Bladder in Male Patient

Musayev JS1*, Bagirov AM2, Hasanov AB1 and Mammadov E3

1Department of Pathology, Azerbaijan Medical University, Azerbaijan

2Department of Urology, Azerbaijan Medical University, Azerbaijan

3Department of Urology, Medical Plaza Private Hospital, Azerbaija

*Corresponding author: Musayev JS, Department of Pathology, Azerbaijan Medical University, Patoloji Anatomiya Burosu, Sherifzade 212, Baku, AZ1012, Azerbaijan

Received: August 07, 2014; Accepted: September 05, 2014; Published: September 10, 2014

Abstract

Leiomyoma is one of common soft tissue tumors with smooth muscle origin. It is rarely in organs of the urinary system and commonly located in the bladder. Intramural localization of leimyoma at the bladder wall is seen rarely and constitutes 7% of all cases. We present a 55-year old male patient with asymptomatic intramural leiomyoma of bladder. The ultrasonographic examination revealed a mass at the right anterolateral aspect of the bladder wall. Subsequent computed tomography demonstrated well circumscribed soft tissue mass with same localization. The mass was resected completely by an open partial cystectomy, under spinal anesthesia. Histopathologically, the case was reported as leimyoma with no special features. The patient was asymptomatic during 25 months follow-up, without any features in control US in the 6th month.

Keywords: Bladder; Leiomyoma; Intramural; Male; Histopathology

Introduction

Leiomyoma is one of common soft tissue tumors with smooth muscle origin. Prognosis is good due to the benign behavior of these lesions. Frequent localization for leiomyoma is uterus. They are rarely in organs of the urinary system and commonly found in the bladder [1]. These tumors can exhibit intramural, endovesical and extravesical localization at the bladder wall, and intramural leiomyomas are uncommon ones within them. Female to male ratio for bladder leiomyoma is 3:1 [2]. Main form of presentation is obstructive and irritative lower urinary tract symptoms or gross hematuria [3]. Although bladder leiomyomas may be asymptomatic also. Here, a case of intramural leiomyoma of bladder in male patient is being presented.

Case Presentation

A 55-year old male patient was admitted to Urology department for control ultrasonography (US) due to the chronic prostatitis in history. The US examination revealed a mass at the right anterolateral aspect of the bladder wall. The patient didn’t have any complaints. Subsequent computed tomography (CT) demonstrated well circumscribed soft tissue mass with same localization (Figure 1). On cystoscopy, the existence of a mass with smooth urothelial covering observed at the bladder wall. The mass was resected completely by an open partial cystectomy, under spinal anesthesia. Macroscopically, the specimen was 20×25×30 mm in size with a small amount of surrounding soft tissue, unilaterally mucosa covered, white-gray colored on sectioning and nodular in appearance (Figures 2a, 2b). In histopathological examination of material, tumor was composed mature smooth muscle tissue consisting of spindle cells uniform and elongated (cigar-shaped) nucleuses. There were no atypical features, mitotic figures or coagulative T-cell necrosis (Figure 3). The immunohistochemical study revealed the diffuse positivity with smooth muscle acting in the spindle cells formed the tumor. A case was reported as leimyoma with no special features. The patient was discharged after 3 days with no immediate complications and he was asymptomatic during 25 months follow-up, without any features in control US in the 6th month.