Bladder leiomyosarcoma in a patient with chronic ketamine abuse: A case report

Abstract

Cite as: Can Urol Assoc J 2015;9(7-8):E514-6. http://dx.doi.org/10.5489/cuaj.2662 Published online July 17, 2015. AbstractBladder leiomyosarcoma is a rare mesenchymal tumour, accounting for less than 0.5% of all primary bladder malignancies. Adult women of reproductive age have the higher incidence of bladder leiomyosarcoma. Exposure to local pelvic radiotherapy or systemic chemotherapy, especially cyclophosphamide therapy, is also a significant risk factor. We describe a case of a 31-year-old male who developed urinary bladder leiomyosarcoma. The patient had no history of radiotherapy, systemic chemotherapy, or other significant event, except a 5-year history of ketamine abuse. The tumour was found on the left bladder wall and was definitively diagnosed by transurethral resection of the bladder tumour. A partial cystectomy was performed. There are no known reports of urinary bladder leiomyosarcoma associated with chronic ketamine abuse; therefore, we speculate that chronic ketamine abuse may be a factor in the development of this infrequent bladder malignancy.

Ketamine uropathy: Clinical experience in a high prevalence center

“…All biopsies taken at cystodistension confirmed ketamine cystitis with no cases of neoplasia and therefore given the increased perforation risk we do not recommended routine biopsy in the absence of an obvious lesion. We believe the only indications for diagnostic cystoscopy are to investigate visible hematuria as there are two case reports of malignancy within the bladder in patients presenting with ketamine cystitis 17,18 ; however, the histology was atypical and unclear whether related to ketamine use.…”

A brief review and case report of urothelial carcinoma and metachronous leiomyosarcoma of the bladder at the same anatomic region

“…One of them is the relationship between long-term chemotherapy of cyclophosphamide and bladder sarcoma, and a minority reports have revealed this point. Apart of above mentioned, the presence of urinary bladder diverticulum, abuse use of ketamine, 3 and radiation exposure, 4 could be a contribution of risk factor to this rarity. We could not discern any those factors, while our patient had a history of smoking and type II diabetes mellitus.…”

British Association of Urological Surgeons Consensus statements on the management of ketamine uropathy

“…The BAUS Female, Neurological and Urodynamic Urology Section (FNUU) Executive Committee comprises a group of urological surgeons elected by their peers due to their interest in the field of female urology, neurourology, urodynamics and reconstruction of the urinary tract. It was identified that ketamine-related uropathy is an important and challenging Raretwo case reports of development of leiomyoma [10] and primary yolk sac tumour [11] of the bladder after persistent ketamine misuse ED, erectile dysfunction; LFT, liver function test.…”