Bladder leiomyoma: Presentation, evaluation and treatment

Abstract

BackgroundBladder leiomyomas are benign mesenchymal neoplasms and very rare urinary tumours that represent <0.5% of all bladder tumours, with only 250 cases reported worldwide to date. The importance of recognising their characteristic features, leading to their correct treatment, is fundamental. Therefore, we reviewed reports of leiomyomas of the urinary bladder, their causes, clinical presentations, imaging methods and surgical management, updated to 2012.MethodsWe retrospectively reviewed articles published in the USA, Europe and Asia, from 1953 to date, using PubMed, Medscape, Medline and the several major journals. We report areas of controversies and well-established guidelines.ResultsWe reviewed 36 articles that confirmed, with a high level of evidence-based medicine, that the male to female ratio is equal, the cause of bladder leiomyomas remains unknown, and their most common presentation is obstructive uropathy; endovesical tumours are the most common. Their radiological diagnosis can be made by ultrasonography, computed tomography or magnetic resonance imaging. Complete surgical resection is a very effective treatment, associated with almost no recurrence.ConclusionIn symptomatic patients a complete surgical resection can give a very good outcome, with almost no recurrence.

Transurethral Enucleation of Bladder Leiomyoma: A Series of Six Cases and Review of the Literature

“…For large tumors, an open resection is required, such as simple enucleation and partial cystectomy. Recently, laparoscopic partial cystectomy and robot-assisted partial cystectomy excision have been successfully applied for bladder leiomyoma treatment [5,21,22]. Silva-Ramos et al [23] performed a pooled analysis of 90 leiomyoma cases.…”

“…Imaging techniques including ultrasound, CT and MRI might help provide more positive evidence for diagnosis. Ultrasound has been considered the most sensitive and affordable of these techniques [5]. Pelvic ultrasound can detect a hypoechoic or mildly hyperechoic homogeneous mass in the bladder and provide information on its relationship with the uterus and vagina [12] (Fig.…”

“…Treatment is determined primarily according to the size and anatomical location of the tumors. Small endovesical bladder leiomyomas can be removed by transurethral resection of the bladder tumor (TURBT), but open resection is more effective for large-sized intramural or extravesical leiomyomas [5]. We present a series of 6 cases with bladder leiomyoma (Table 1) who have undergone transurethral enucleation of the mass.…”

Bladder Leiomyoma with Synchronous Solitary Fibrous Tumor of the Pleura

“…Several theories have been proposed for the interpretation of their development such as hormonal disorders, vestigial remnants in the bladder, perivascular inflammation-metaplasia of bladder structures, chromosomal abnormalities, and bladder wall infection or inflammation [2]. They are usually asymptomatic (80%) [1], manifesting rarely with hematuria and urge or obstructive urination depending on the localization (endovesical: 63%, extravesical: 30%, and intramural: 7%) [2,3]. Solitary fibrous tumors (SFTs) are also very rare tumors of mesenchymal origin, usually affecting the pleura.…”

Leiomioma vesical de crecimiento extramural: Una presentación infrecuente – reporte de caso

“…Pueden ser hallados en cualquier parte del tracto urinario, la mayoría se originan en la vejiga y corresponden al 1%-5% de los tumores de vejiga. [1][2][3][4] Se presentan con mayor frecuencia en la población femenina y deben ser considerados como diagnóstico diferencial en cualquier tumor de vejiga. 1 Son tumores que pueden ser asintomáticos a menos que afecten la función del tracto urinario inferior, generando síntomas urinarios obstructivos, irritativos y/o hematuria.…”