Elderly patient with atypical leiomyoma of the bladder presenting as flank pain: A case report

Ameli, Mojtaba; Rahmandoost, Mina

doi:10.4081/aiua.2017.4.327

Cited by 4 publications

(3 citation statements)

References 4 publications

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“…Our case was asymptomatic except for microhematuria. However, since various symptoms, such as urinary retention, hematuria, and dyspareunia, are possible[ 4 , 7 - 12 ], a thorough history is necessary. In a review by Goluboff et al [ 4 ], 49% of the 37 patients presented with obstructive symptoms, 38% showed irritative symptoms, 11% had hematuria, and 19% were asymptomatic.…”

Section: Discussionmentioning

confidence: 99%

“…In a case report by Xin et al [ 10 ], a 44-year-old female with dyspareunia was diagnosed with bladder leiomyoma coexisting with uterine leiomyoma on histological examination. Saidi et al [ 11 ] reported leiomyoma of the urinary bladder presenting with hematuria, and Ameli et al [ 12 ] reported atypical leiomyoma of the bladder presenting as flank pain.…”

Section: Discussionmentioning

confidence: 99%

“…Cystoscopy is a high-value diagnostic tool that can show the leiomyoma’s morphology and anatomical location[ 12 ]. Moreover, cystoscopy can be used to confirm the histopathology of bladder mass.…”

Section: Discussionmentioning

confidence: 99%

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Recurrent atypical leiomyoma in bladder trigone, confused with uterine fibroids: A case report

Song¹,

Song²,

Kim³

2022

World J Clin Cases

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BACKGROUND Tumors originating from the posterior bladder wall can be challenging to diagnose because they may mimic a mass from the uterine cervix. Atypical leiomyoma of the bladder trigone is extremely rare, with few reported cases, and requires caution during surgery to avoid damage to the adjacent ureter. Diagnostic surgery and confirmational pathology are essential to assess whether the tumor is malignant and relieve clinical symptoms. Herein, we describe a case of recurrent leiomyoma with focal atypia in the bladder trigone. CASE SUMMARY A 29-year-old woman with a uterine fibroid incidentally found at a regular checkup was referred to our hospital. Based on magnetic resonance imaging, either urinary bladder leiomyoma or protrusion of pedunculated uterine cervical fibroid into the bladder was suspected. This leiomyoma in the trigone of the bladder was completely excised by laparotomy, and the patient was discharged without complication. Follow-up outpatient ultrasonography identified tumor recurrence after four years. As focal atypia was identified previously, laparotomy was performed to confirm the pathology. A round solid mass was resected from the posterior bladder wall without injuring either ureteric orifice. This tumor was pathologically diagnosed as a leiomyoma without atypia. Three-year follow-up ultrasonography has revealed no recurrence. CONCLUSION Atypical leiomyoma in bladder trigone is rare and could be easily mistaken for fibroid in the uterine cervix. To confirm histopathology, surgical excision is mandatory and regular follow-up is necessary to detect recurrence.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Recurrent atypical leiomyoma in bladder trigone, confused with uterine fibroids: A case report

Song¹,

Song²,

Kim³

2022

World J Clin Cases

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Bladder leiomyoma masquerading as a ureterocele

et al. 2021

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We present a unique case of bladder leiomyoma that was mistakenly diagnosed as a ureterocele. The delay in diagnosis meant ongoing significant voiding lower urinary tract symptoms, which could have been avoided. This was eventually successfully treated by transurethral resection. Leiomyoma is the most common benign bladder mass and should be considered in the differential diagnosis when a smooth mass with normal overlying mucosa is seen on cystoscopy or a homogeneous, low density bladder mass is seen on cross-sectional imaging. Despite the benign nature of the lesion, leiomyoma can convey significant morbidity to the patient.

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Characteristics and outcomes in bladder Leiomyoma management: a systematic review of case reports and case series from the past 20 years

Prihadi,

Hengky,

Lionardi

et al. 2024

BMC Urol

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Introduction Bladder leiomyomas (LM) are uncommon, non-cancerous growths that originate from the smooth muscle cells of the bladder and constitute 0.5% of bladder tumor cases. This review aims to compile existing data and present a summary of bladder leiomyomas’ characteristics, management, and related outcomes. Method We conducted systematic review of studies that investigated bladder leiomyoma. Case studies or series describing individuals with bladder leiomyoma who underwent surgery and the outcomes were included. Four databases were used in our literature search, which was carried out until January 2024: PubMed, Proquest, EBSCOHost, and Google Scholar. We utilized MeSH terms such as “leiomyoma,” “urinary bladder,” and looked for synonyms of “bladder leiomyoma” in free text. Results A total of 99 studies with 119 patients were included. Most reported bladder leiomyoma cases were female, accounting for 79.0% of all cases. While symptomatic patients primarily presented with lower urinary tract symptoms (LUTS) (59.7%), hematuria (24.4%), acute urine retention (11.8%), and about 16.8% of cases were incidentally detected. Storage-related symptoms were the most common LUTS (37.0%). Different diagnostic techniques were used, frequently combining CT (Computed Tomography), MRI (Magnetic Resonance Imaging), USG (Ultrasonography), and/or cystoscopy. Bladder leiomyomas were commonly found on the left lateral wall (26.9%) and the bladder neck (17.6%). In more than half of the cases (52.1%) the treatment techniques used were transurethral resection (TURBt/TUR). Fifteen out of 119 cases (12.6%) had recurrence or remain symptomatic. Symptomatic symptoms at first presentation and extended location are frequently found among recurrent or symptomatic cases after first management. Conclusion Management of bladder leiomyoma should focus on the relief of symptoms and recurrence and be personalized based on the tumor characteristics, patient symptoms, and surgeon’s expertise. Further investigation is necessary to fully understand the best course of treatment and long-term results for bladder leiomyomas. In particular, prospective trials with bigger participant pools and meticulously controlled factors should be the main emphasis of this research. Supplementary Information The online version contains supplementary material available at 10.1186/s12894-024-01624-3.

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Elderly patient with atypical leiomyoma of the bladder presenting as flank pain: A case report

Cited by 4 publications

References 4 publications

Recurrent atypical leiomyoma in bladder trigone, confused with uterine fibroids: A case report

Recurrent atypical leiomyoma in bladder trigone, confused with uterine fibroids: A case report

Bladder leiomyoma masquerading as a ureterocele

Characteristics and outcomes in bladder Leiomyoma management: a systematic review of case reports and case series from the past 20 years

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