1986 Volume 77 Issue 5 Pages 827-833
A 73 year-old man visited our hospital with a complaint of gross hematuria on August 24, 1983. Cystoscopy revealed a large pedunculated papillary tumor arising from right side of the trigone. Physical examination showed a large movable mass on the left side of the abdomen. Transurethral resection was performed for the bladder tumor. Pathological diagnosis was TCC, G3, pTaNOMO (transitional cell carcinoma, grade 3, stage pTaNOMO). The abdominal mass was studied by gastrointestinal fluoroscopy, endoscopy and CT scan and diagnosed as submucosal tumor of the stomach. The abdominal tumor was removed by subtotal gastrectomy with a resection of transverse colon. Regional lymph nodes were dissected. Histologically it was a leiomyosarcoma of the stomach invading into the colon. Both tumors recurred 5 months after the abdominal surgery. Transurethral resection was performed again for the multiple recurrent bladder tumors. After the transarterial embolization of the right hepatic artery, laparotomy was perfomed but the liver metastasis of leiomyosarcoma was not resectable. The patient died of cancer on July 23, 1984.
In the Japanese literature, we have collected 46 cases of multiple primary malignant neoplasms of genitourinary organs composed of at least one non-epithelial malignancy. Male patients were dominant at the sex ratio of 3 to 1. Of These, synchronous cases were 69% (22/32). The combination of genitourinary cancer and non-epithelial malignancy in the other organs were 40 cases. Of the 40 cases, the bladder cancer in the genitourinary cancer (23 cases) and sarcoma in non-epithelial malignancy (20 cases) were the most frequent. 7 cases of malignant lymphoma and 5 of rhabdomyosarcoma were found. Leiomyosarcoma was found only 2 cases. This is the first report of bladder cancer associated with gastric leiomyosarcoma.
