Skip to main content

Mesenchymal Tumors

  • Chapter
  • First Online:
Urinary Bladder Pathology

Abstract

Mesenchymal tumors of the urinary bladder sometimes pose a challenge to pathologists and have the potential to be misdiagnosed. These tumors are rare, thought to comprise less than 1% of all bladder tumors. A number of mesenchymal tumors are reported in the literature as single case reports or a small series of cases, which makes it difficult to accurately estimate their true incidence. Reports of sarcomas before the advent of newer immunohistochemical antibodies raise the question of whether some of these are true primary sarcomas of the urinary bladder or sarcomatoid carcinomas misdiagnosed as sarcoma. There are various types of stromal cells within the urinary bladder wall that are the precursors of these benign and malignant tumors. In addition, there are “tumor-like lesions,” such as the postoperative spindle cell nodule, which on cystoscopy are also visualized as a mass. In this chapter, we briefly describe the most common benign and malignant tumors and tumor-like lesions of the urinary bladder.

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

Access this chapter

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Beilan JA, Lawton A, Hajdenberg J, Rosser CJ. Pheochromocytoma of the urinary bladder: a systematic review of the contemporary literature. BMC Urol. 2013;13:22.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Giubellino A, Lara K, Martucci V, Huynh T, Agarwal P, Pacak K, et al. Urinary bladder paragangliomas: how immunohistochemistry can assist to identify patients with SDHB germline and somatic mutations. Am J Surg Pathol. 2015;39(11):1488–92.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Cheng L, Leibovich BC, Cheville JC, Ramnani DM, Sebo TJ, Neumann RM, et al. Paraganglioma of the urinary bladder: can biologic potential be predicted? Cancer. 2000;88(4):844–52.

    Article  CAS  PubMed  Google Scholar 

  4. So JS, Epstein JI. GATA3 expression in paragangliomas: a pitfall potentially leading to misdiagnosis of urothelial carcinoma. Mod Pathol. 2013;26(10):1365–70.

    Article  CAS  PubMed  Google Scholar 

  5. Park S, Kang SY, Kwon GY, Kwon JE, Kim SK, Kim JY, et al. Clinicopathologic Characteristics and Mutational Status of Succinate Dehydrogenase Genes in Paraganglioma of the Urinary Bladder: A Multi-Institutional Korean Study. Arch Pathol Lab Med. 2017;141(5):671–7.

    Article  CAS  PubMed  Google Scholar 

  6. Mason EF, Sadow PM, Wagner AJ, Remillard SP, Flood TA, Belanger EC, et al. Identification of succinate dehydrogenase-deficient bladder paragangliomas. Am J Surg Pathol. 2013;37(10):1612–8.

    Article  PubMed  Google Scholar 

  7. Martin SA, Sears DL, Sebo TJ, Lohse CM, Cheville JC. Smooth muscle neoplasms of the urinary bladder: a clinicopathologic comparison of leiomyoma and leiomyosarcoma. Am J Surg Pathol. 2002;26(3):292–300.

    Article  PubMed  Google Scholar 

  8. Knoll LD, Segura JW, Scheithauer BW. Leiomyoma of the bladder. J Urol. 1986;136(4):906–8.

    Article  CAS  PubMed  Google Scholar 

  9. 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 

  10. Kaefer M, Adams MC, Rink RC, Keating MA. Principles in management of complex pediatric genitourinary plexiform neurofibroma. Urology. 1997;49(6):936–40.

    Article  CAS  PubMed  Google Scholar 

  11. 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 

  12. Cummings JM, Wehry MA, Parra RO, Levy BK. Schwannoma of the urinary bladder: a case report. Int J Urol. 1998;5(5):496–7.

    Article  CAS  PubMed  Google Scholar 

  13. Olaya M, Vicioso L, Hierro I, Quinonero A, Matilla A, Lopez-Beltran A. Granular cell tumor of the bladder: a case report. Anal Quant Cytopathol Histpathol. 2013;35(5):289–93.

    PubMed  Google Scholar 

  14. Tsui JF, Weinberger JM, Kashan M, Weiss JP, Robinson BD, Blaivas JG. Bladder lipoma. J Urol. 2013;190(4):1387–8.

    Article  PubMed  Google Scholar 

  15. Chen CH, Boag AH, Beiko DT, Siemens DR, Froese A, Isotalo PA. Composite paraganglioma-ganglioneuroma of the urinary bladder: a rare neoplasm causing hemodynamic crisis at tumour resection. Can Urol Assoc J. 2009;3(5):E45–8.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Lasota J, Carlson JA, Miettinen M. Spindle cell tumor of urinary bladder serosa with phenotypic and genotypic features of gastrointestinal stromal tumor. Arch Pathol Lab Med. 2000;124(6):894–7.

    Article  CAS  PubMed  Google Scholar 

  17. Mills SE, Bova GS, Wick MR, Young RH. Leiomyosarcoma of the urinary bladder. A clinicopathologic and immunohistochemical study of 15 cases. Am J Surg Pathol. 1989;13(6):480–9.

    Article  CAS  PubMed  Google Scholar 

  18. Kunze E, Theuring F, Kruger G. Primary mesenchymal tumors of the urinary bladder. A histological and immunohistochemical study of 30 cases. Pathol Res Pract. 1994;190(4):311–32.

    Article  CAS  PubMed  Google Scholar 

  19. Iczkowski KA, Shanks JH, Gadaleanu V, Cheng L, Jones EC, Neumann R, et al. Inflammatory pseudotumor and sarcoma of urinary bladder: differential diagnosis and outcome in thirty-eight spindle cell neoplasms. Mod Pathol. 2001;14(10):1043–51.

    Article  CAS  PubMed  Google Scholar 

  20. Russo P, Brady MS, Conlon K, Hajdu SI, Fair WR, Herr HW, et al. Adult urological sarcoma. J Urol. 1992;147(4):1032–6.

    Article  CAS  PubMed  Google Scholar 

  21. Rosser CJ, Slaton JW, Izawa JI, Levy LB, Dinney CP. Clinical presentation and outcome of high-grade urinary bladder leiomyosarcoma in adults. Urology. 2003;61(6):1151–5.

    Article  PubMed  Google Scholar 

  22. Wick MR, Brown BA, Young RH, Mills SE. Spindle-cell proliferations of the urinary tract. An immunohistochemical study. Am J Surg Pathol. 1988;12(5):379–89.

    Article  CAS  PubMed  Google Scholar 

  23. Raney B Jr, Heyn R, Hays DM, Tefft M, Newton WA Jr, Wharam M, et al. Sequelae of treatment in 109 patients followed for 5 to 15 years after diagnosis of sarcoma of the bladder and prostate. A report from the Intergroup Rhabdomyosarcoma Study Committee. Cancer. 1993;71(7):2387–94.

    Article  PubMed  Google Scholar 

  24. Leuschner I, Harms D, Mattke A, Koscielniak E, Treuner J. Rhabdomyosarcoma of the urinary bladder and vagina: a clinicopathologic study with emphasis on recurrent disease: a report from the Kiel Pediatric Tumor Registry and the German CWS Study. Am J Surg Pathol. 2001;25(7):856–64.

    Article  CAS  PubMed  Google Scholar 

  25. Ortega JA, Rowland J, Monforte H, Malogolowkin M, Triche T. Presence of well-differentiated rhabdomyoblasts at the end of therapy for pelvic rhabdomyosarcoma: implications for the outcome. J Pediatr Hematol Oncol. 2000;22(2):106–11.

    Article  CAS  PubMed  Google Scholar 

  26. 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 

  27. Seethala RR, Gomez JA, Vakar-Lopez F. Primary angiosarcoma of the bladder. Arch Pathol Lab Med. 2006;130(10):1543–7.

    Article  PubMed  Google Scholar 

  28. Ghalayini IF, Bani-Hani IH, Almasri NM. Osteosarcoma of the urinary bladder occurring simultaneously with prostate and bowel carcinomas: report of a case and review of the literature. Arch Pathol Lab Med. 2001;125(6):793–5.

    Article  CAS  PubMed  Google Scholar 

  29. Torenbeek R, Blomjous CE, Meijer CJ. Chondrosarcoma of the urinary bladder: report of a case with immunohistochemical and ultrastructural findings and review of the literature. Eur Urol. 1993;23(4):502–5.

    Article  CAS  PubMed  Google Scholar 

  30. Savage N, Linn D, McDonough C, Donohoe JM, Franco A, Reuter V, et al. Molecularly confirmed primary malignant rhabdoid tumor of the urinary bladder: implications of accurate diagnosis. Ann Diagn Pathol. 2012;16(6):504–7.

    Article  PubMed  Google Scholar 

  31. Rober PE, Smith JB, Sakr W, Pierce JM Jr. Malignant peripheral nerve sheath tumor (malignant schwannoma) of urinary bladder in von Recklinghausen neurofibromatosis. Urology. 1991;38(5):473–6.

    Article  CAS  PubMed  Google Scholar 

  32. Huang WL, Ro JY, Grignon DJ, Swanson D, Ordonez NG, Ayala AG. Postoperative spindle cell nodule of the prostate and bladder. J Urol. 1990;143(4):824–6.

    Article  CAS  PubMed  Google Scholar 

  33. 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 

  34. Ro JY, el-Naggar AK, Amin MB, Sahin AA, Ordonez NG, Ayala AG. Pseudosarcomatous fibromyxoid tumor of the urinary bladder and prostate: immunohistochemical, ultrastructural, and DNA flow cytometric analyses of nine cases. Hum Pathol. 1993;24(11):1203–10.

    Article  CAS  PubMed  Google Scholar 

  35. Choi E, Williamson SR, Montironi R, Zhang S, Wang M, Eble JN, et al. Inflammatory myofibroblastic tumour of the urinary bladder: the role of immunoglobulin G4 and the comparison of two immunohistochemical antibodies and fluorescence in-situ hybridization for the detection of anaplastic lymphoma kinase alterations. Histopathology. 2015;67(1):20–38.

    Article  PubMed  Google Scholar 

  36. Tsuzuki T, Magi-Galluzzi C, Epstein JI. ALK-1 expression in inflammatory myofibroblastic tumor of the urinary bladder. Am J Surg Pathol. 2004;28(12):1609–14.

    Article  PubMed  Google Scholar 

  37. Montgomery EA, Shuster DD, Burkart AL, Esteban JM, Sgrignoli A, Elwood L, et al. Inflammatory myofibroblastic tumors of the urinary tract: a clinicopathologic study of 46 cases, including a malignant example inflammatory fibrosarcoma and a subset associated with high-grade urothelial carcinoma. Am J Surg Pathol. 2006;30(12):1502–12.

    Article  PubMed  Google Scholar 

  38. Antonescu CR, Suurmeijer AJ, Zhang L, Sung YS, Jungbluth AA, Travis WD, et al. Molecular characterization of inflammatory myofibroblastic tumors with frequent ALK and ROS1 gene fusions and rare novel RET rearrangement. Am J Surg Pathol. 2015;39(7):957–67.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Westfall DE, Folpe AL, Paner GP, Oliva E, Goldstein L, Alsabeh R, et al. Utility of a comprehensive immunohistochemical panel in the differential diagnosis of spindle cell lesions of the urinary bladder. Am J Surg Pathol. 2009;33(1):99–105.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Pheroze Tamboli .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Hwang, M.J., Tamboli, P. (2021). Mesenchymal Tumors. In: Zhou, H., Guo, C.C., Ro, J.Y. (eds) Urinary Bladder Pathology. Springer, Cham. https://doi.org/10.1007/978-3-030-71509-0_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-71509-0_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-71508-3

  • Online ISBN: 978-3-030-71509-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics