Leiomyosarcomas are a relatively rare tumor entity encountered within the urinary bladder. There are just over 100 cases reported in the medical literature. Herein, we describe a case of leiomyosarcoma presenting initially as a urinary tract infection with lower abdominal pain. A life threatening episode of gross hematuria guided to the final diagnosis and treatment. Due to the rarity of this malignancy, we present this case including a review of the existing literature relative to the diagnosis and treatment.

of Charlestown, aged 48 years, had, for the most part of her life, enjoyed good health. In July, 1828, she was taken with pain in the bowels, accompanied with constipation, vomiting, rigors, &c. The pain was rather unusual, coming on at intervals, and very nearly resembling the pains which take place in the last stage of labor. I made an examination per vaginam, and found the uterus enlarged and apparently pressing hard upon the rectum. She had not menstruated

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