Skip to main content

Advertisement

Log in

Mesenchymal neoplasms of the urinary bladder: a comprehensive review with focus on cross-sectional imaging findings

  • Review
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Mesenchymal neoplasms of the urinary bladder are exceedingly rare and display remarkable diversity. These tumors demonstrate distinct pathological features as well as variable biological behavior and cross-sectional imaging findings. The rarity of tumors, nonspecific symptoms and seemingly normal cystoscopic findings (particularly with small and exophytic tumors) frequently lead to misdiagnosis or missed diagnosis. While some tumors display characteristic cross-sectional imaging findings that may suggest a diagnosis, imaging findings are mostly nonspecific. Histopathological examination is required for accurate diagnosis, management and prognostication. The purpose of this article is to review the cross-sectional imaging findings of a diverse spectrum of mesenchymal tumors of the urinary bladder.

Graphical abstract

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12

Similar content being viewed by others

References

  1. Verma S, Rajesh A, Prasad SR, Gaitonde K, Lall CG, Mouraviev V, et al. Urinary Bladder Cancer: Role of MR Imaging. RadioGraphics. 2012;32(2):371-87.

    Article  PubMed  Google Scholar 

  2. Wong-You-Cheong JJ, Woodward PJ, Manning MA, Sesterhenn IA. From the Archives of the AFIP: neoplasms of the urinary bladder: radiologic-pathologic correlation. Radiographics. 2006;26(2):553-80.

    Article  PubMed  Google Scholar 

  3. Chung AD, Schieda N, Flood TA, Cagiannos I, Kielar AZ, McInnes MD, et al. Suburothelial and extrinsic lesions of the urinary bladder: radiologic and pathologic features with emphasis on MR imaging. Abdom Imaging. 2015;40(7):2573-88.

    Article  PubMed  Google Scholar 

  4. Hatfield BS, Mochel MC, Smith SC. Mesenchymal Neoplasms of the Genitourinary System: A Selected Review with Recent Advances in Clinical, Diagnostic, and Molecular Findings. Surg Pathol Clin. 2018;11(4):837-76.

    Article  PubMed  Google Scholar 

  5. Tavora F, Kryvenko ON, Epstein JI. Mesenchymal tumours of the bladder and prostate: an update. Pathology. 2013;45(2):104-15.

    Article  PubMed  Google Scholar 

  6. Chmielecki J, Crago AM, Rosenberg M, O'Connor R, Walker SR, Ambrogio L, et al. Whole-exome sequencing identifies a recurrent NAB2-STAT6 fusion in solitary fibrous tumors. Nat Genet. 2013;45(2):131-2.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Huang SC, Huang HY. Solitary fibrous tumor: An evolving and unifying entity with unsettled issues. Histol Histopathol. 2019;34(4):313-34.

    CAS  PubMed  Google Scholar 

  8. Mahajan P, Casanova M, Ferrari A, Fordham A, Trahair T, Venkatramani R. Inflammatory myofibroblastic tumor: molecular landscape, targeted therapeutics, and remaining challenges. Curr Probl Cancer. 2021;45(4):100768.

    Article  PubMed  Google Scholar 

  9. Coffin CM, Hornick JL, Fletcher CD. Inflammatory myofibroblastic tumor: comparison of clinicopathologic, histologic, and immunohistochemical features including ALK expression in atypical and aggressive cases. Am J Surg Pathol. 2007;31(4):509-20.

    Article  PubMed  Google Scholar 

  10. Ahmadi H, Duddalwar V, Daneshmand S. Diagnosis and Staging of Bladder Cancer. Hematol Oncol Clin North Am. 2021;35(3):531-41.

    Article  PubMed  Google Scholar 

  11. Mirmomen SM, Shinagare AB, Williams KE, Silverman SG, Malayeri AA. Preoperative imaging for locoregional staging of bladder cancer. Abdom Radiol (NY). 2019;44(12):3843-57.

    Article  PubMed  Google Scholar 

  12. Katabathina VS, Rajebi H, Chen M, Restrepo CS, Salman U, Vikram R, et al. Genetics and imaging of pheochromocytomas and paragangliomas: current update. Abdom Radiol (NY). 2020;45(4):928-44.

    Article  PubMed  Google Scholar 

  13. Surabhi VR, Chua S, Patel RP, Takahashi N, Lalwani N, Prasad SR. Inflammatory Myofibroblastic Tumors: Current Update. Radiol Clin North Am. 2016;54(3):553-63.

    Article  PubMed  Google Scholar 

  14. Carrasquillo JA, Chen CC, Jha A, Ling A, Lin FI, Pryma DA, et al. Imaging of Pheochromocytoma and Paraganglioma. J Nucl Med. 2021;62(8):1033-42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Helpap B. Nonepithelial neoplasms of the urinary bladder. Virchows Archiv. 2001;439(4):497-503.

    Article  CAS  PubMed  Google Scholar 

  16. Lu H, Male M, Jiang K, Ye Z, Song D, Xia D. Clinical significance of functional and anatomical classifications in paraganglioma of the urinary bladder. Urol Oncol. 2019;37(6):354 e9- e17.

  17. Coffin CM, Watterson J, Priest JR, Dehner LP. Extrapulmonary inflammatory myofibroblastic tumor (inflammatory pseudotumor). A clinicopathologic and immunohistochemical study of 84 cases. Am J Surg Pathol. 1995;19(8):859–72.

  18. Harik LR, Merino C, Coindre JM, Amin MB, Pedeutour F, Weiss SW. Pseudosarcomatous myofibroblastic proliferations of the bladder: a clinicopathologic study of 42 cases. Am J Surg Pathol. 2006;30(7):787-94.

    Article  PubMed  Google Scholar 

  19. Hoekman K, van Doorn J, Gloudemans T, Maassen JA, Schuller AG, Pinedo HM. Hypoglycaemia associated with the production of insulin-like growth factor II and insulin-like growth factor binding protein 6 by a haemangiopericytoma. Clin Endocrinol (Oxf). 1999;51(2):247-53.

    Article  CAS  PubMed  Google Scholar 

  20. Lee TK, Miyamoto H, Osunkoya AO, Guo CC, Weiss SW, Epstein JI. Smooth muscle neoplasms of the urinary bladder: a clinicopathologic study of 51 cases. Am J Surg Pathol. 2010;34(4):502-9.

    Article  PubMed  Google Scholar 

  21. Mouli S, Casalino DD, Nikolaidis P. Imaging features of common and uncommon bladder neoplasms. Radiol Clin North Am. 2012;50(2):301–16, vi.

  22. Tanguay C, Harvey I, Houde M, Srigley JR, Tetu B. Leiomyosarcoma of urinary bladder following cyclophosphamide therapy: report of two cases. Mod Pathol. 2003;16(5):512-4.

    Article  CAS  PubMed  Google Scholar 

  23. Zukerman Z, Schiavina R, Borghesi M, Brunocilla E, Vagnoni V, Pirini MG, et al. Smooth muscle tumor of uncertain malignant potential of the urinary bladder: a case report and review of the literature. Clin Genitourin Cancer. 2013;11(4):e6-9.

    Article  PubMed  Google Scholar 

  24. Keraliya AR, Tirumani SH, Shinagare AB, Zaheer A, Ramaiya NH. Solitary Fibrous Tumors: 2016 Imaging Update. Radiol Clin North Am. 2016;54(3):565-79.

    Article  PubMed  Google Scholar 

  25. Shanbhogue AK, Prasad SR, Takahashi N, Vikram R, Zaheer A, Sandrasegaran K. Somatic and visceral solitary fibrous tumors in the abdomen and pelvis: cross-sectional imaging spectrum. Radiographics. 2011;31(2):393-408.

    Article  PubMed  Google Scholar 

  26. Acosta AM, Demicco EG, Dal Cin P, Hirsch MS, Fletcher CDM, Jo VY. Pseudosarcomatous myofibroblastic proliferations of the urinary bladder are neoplasms characterized by recurrent FN1-ALK fusions. Mod Pathol. 2021;34(2):469-77.

    Article  CAS  PubMed  Google Scholar 

  27. Shelmerdine SC, Lorenzo AJ, Gupta AA, Chavhan GB. Pearls and Pitfalls in Diagnosing Pediatric Urinary Bladder Masses. Radiographics. 2017;37(6):1872-91.

    Article  PubMed  Google Scholar 

  28. Tavora F, Montgomery E, Epstein JI. A series of vascular tumors and tumorlike lesions of the bladder. Am J Surg Pathol. 2008;32(8):1213-9.

    Article  PubMed  Google Scholar 

  29. Cheng L, Nascimento AG, Neumann RM, Nehra A, Cheville JC, Ramnani DM, et al. Hemangioma of the urinary bladder. Cancer. 1999;86(3):498-504.

    Article  CAS  PubMed  Google Scholar 

  30. Lee C, Kim B, Song B, Park JH, Moon KC. Clinicopathologic Features of Benign Neurogenic Tumor of Urinary Bladder. Int J Surg Pathol. 2018;26(3):221-8.

    Article  PubMed  Google Scholar 

  31. Cheng L, Scheithauer BW, Leibovich BC, Ramnani DM, Cheville JC, Bostwick DG. Neurofibroma of the urinary bladder. Cancer. 1999;86(3):505-13.

    Article  CAS  PubMed  Google Scholar 

  32. Kriegshauser JS, Conley CR, Hentz JG. Bladder wall fat on computed tomography with pathologic correlation. Clin Imaging. 2013;37(3):509-13.

    Article  PubMed  Google Scholar 

  33. Folpe AL, Kwiatkowski DJ. Perivascular epithelioid cell neoplasms: pathology and pathogenesis. Hum Pathol. 2010;41(1):1-15.

    Article  CAS  PubMed  Google Scholar 

  34. Prasad SR, Sahani DV, Mino-Kenudson M, Narra VR, Humphrey PA, Menias CO, et al. Neoplasms of the perivascular epithelioid cell involving the abdomen and the pelvis: cross-sectional imaging findings. J Comput Assist Tomogr. 2007;31(5):688-96.

    Article  PubMed  Google Scholar 

  35. Wu YL, Lang L, Ma Q, Wu F, Zhang Y, Chen W, et al. Perivascular Epithelioid Cell Tumor of Urinary Bladder. Am J Clin Pathol. 2021;156(1):56-71.

    Article  CAS  PubMed  Google Scholar 

  36. Neumann NM, Haffner MC, Argani P, Kao CS, Epstein JI. Histopathologic Characterization of Bladder Perivascular Epithelioid Cell Neoplasms (PEComa): A Series of 11 Cases With a Subset Having TFE3 Rearrangements. Am J Surg Pathol. 2021;45(2):169-77.

    Article  PubMed  Google Scholar 

  37. Williamson SR, Bunde PJ, Montironi R, Lopez-Beltran A, Zhang S, Wang M, et al. Malignant perivascular epithelioid cell neoplasm (PEComa) of the urinary bladder with TFE3 gene rearrangement: clinicopathologic, immunohistochemical, and molecular features. Am J Surg Pathol. 2013;37(10):1619-26.

    Article  PubMed  Google Scholar 

  38. Xuesong D, Hong G, Weiguo Z. Bladder Perivascular Epithelioid Cell Tumor: Dynamic CT and MRI Presentation of 2 Cases With 2-year Follow-up and Review of the Literature. Clin Genitourin Cancer. 2019;17(5):e916-e22.

    Article  PubMed  Google Scholar 

  39. Tirumani SH, Shinagare AB, Hargreaves J, Jagannathan JP, Hornick JL, Wagner AJ, et al. Imaging features of primary and metastatic malignant perivascular epithelioid cell tumors. AJR Am J Roentgenol. 2014;202(2):252-8.

    Article  PubMed  Google Scholar 

  40. Crona J, Taieb D, Pacak K. New Perspectives on Pheochromocytoma and Paraganglioma: Toward a Molecular Classification. Endocr Rev. 2017;38(6):489-515.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Sajjan RS, Gavra M, Agrawal K, Syed R, Bomanji J. 68Ga-DOTATATE PET/MR Imaging of Urinary Bladder Paraganglioma. Clin Nucl Med. 2015;40(8):692-4.

    Article  PubMed  Google Scholar 

  42. Roman-Gonzalez A, Jimenez C. Malignant pheochromocytoma-paraganglioma: pathogenesis, TNM staging, and current clinical trials. Curr Opin Endocrinol Diabetes Obes. 2017;24(3):174-83.

    Article  PubMed  Google Scholar 

  43. Nguyen A, Fassas S, Freidberg N, Sullo E, Whalen M. Recurrence and treatment of adult primary nonmetastatic bladder rhabdomyosarcoma: A systematic review. Urol Oncol. 2021;39(11):774-80.

    Article  PubMed  Google Scholar 

  44. Nigro KG, MacLennan GT. Rhabdomyosarcoma of the bladder and prostate. J Urol. 2005;173(4):1365.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Srinivasa R. Prasad.

Ethics declarations

Conflict of interest

Authors have no relevant disclosures.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Balasubramanya, R., Shanbhogue, A.K., Ramani, N.S. et al. Mesenchymal neoplasms of the urinary bladder: a comprehensive review with focus on cross-sectional imaging findings. Abdom Radiol 47, 2881–2895 (2022). https://doi.org/10.1007/s00261-022-03568-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-022-03568-4

Keywords

Navigation