Bladder urothelial carcinoma complicated with spindle-cell malignancy and giantcell osteosarcoma differentiation:one case report and literature review
10.12483/j.issn.1009-8291.2026.01.009
- VernacularTitle:膀胱尿路上皮癌合并梭形细胞恶性肿瘤伴巨细胞骨肉瘤分化的膀胱癌肉瘤1例报告并文献复习
- Author:
Hongfang ZHENG
1
;
Song JIANG
1
;
Song XU
2
Author Information
1. Department of Urology, The First Peopleˊs Hospital of Kunshan City, Kunshan 215300, China
2. Department of Pathology, The First Peopleˊs Hospital of Kunshan City, Kunshan 215300, China
- Publication Type:Journal Article
- Keywords:
bladder tumor;
urothelial carcinoma;
bladder carcinosarcoma;
malignant spindle cell tumor
- From:
Journal of Modern Urology
2026;31(1):46-50
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the diagnostic and therapeutic strategies of bladder carcinosarcoma, so as to provide clinical reference. Methods This article reported a case of bladder urothelial carcinoma with spindle cell malignant tumor and giant-cell osteosarcoma differentiation in the Department of Urology of the First People's Hospital of kunshan. Based on literature analysis, the clinical characteristics, diagnostic methods, treatment plan of the disease were analyzed. Results The patient, a 75-year-old male, was admitted due to three months of painless gross hematuria, The abdominal enhanced CT scan revealed an irregular solid mass on the left wall of the bladder, measured approximately 6 cm×7 cm, which showed significant enhancement after contrast administration. Biopsy pathology indicated transitional cell carcinoma of the urothelium with squamous metaplasia and moderate atypical hyperplasia, with spindle-shaped cells in the stroma showing bizarre nuclei. Under general anesthesia, the patient received transurethral resection of the bladder tumor. Postoperative pathology showed lowgrade urothelial carcinoma of the bladder with squamous metaplasia, complicated with malignant spindle-cell tumor, which had osteosarcoma-like giant-cell differentiation, suggesting a diagnosis of carcinosarcoma of the bladder. The patient received intravesical gemcitabine treatment for two years postoperatively, with regular follow-ups. No tumor recurrence was observed over four years, and he is still alive. Combined with previous published literature, the disease is mostly manifested as painless gross hematuria. If the submucosa or muscle layer is invaded, the patient will quickly develop tumor recurrence and metastasis. The diagnosis depends on pathology, and the treatment is mainly radical cystectomy combined with chemoradiotherapy. Conclusion Bladder carcinosarcoma is an extremely rare subtype of bladder cancer. This highly aggressive malignancy primarily affects elderly patients. The current standardized treatment involves radical cystectomy combined with chemotherapy and radiotherapy.For some early-stage cases, intravesical chemotherapy after tumor resection may be more appropriate.
