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Background Granular cell tumor (GCT) is a neurogenic tumor mainly occurring in the head and neck. GCT in the genitourinary system is extremely rare and only sporadic cases of urinary bladder GCT have been reported. Most urinary bladder GCT cases are benign and only two malignant cases have been reported. Due to its rarity, no consensus criteria for the treatment of urinary bladder GCT are available at present. Case summary A 62-year-old Chinese woman was found to have a urinary bladder tumor without any clinical manifestations on physical examination. Cystoscopy revealed a semispherical shaped lesion measuring approximately 4.0 cm in diameter at the junction of the left wall and roof of the bladder, which was covered with normal bladder mucosa. Computed tomography scan demonstrated a high-density lesion on the left wall of the bladder, measuring approximately 2.9 cm × 2.4 cm with clear boundaries. Contrast-enhanced pelvic magnetic resonance imaging revealed a space-occupying lesion on the left wall of the bladder (non-mucosal origin/ external pressure), which was preliminarily suspected to be a desmoplastic fibroma or leiomyoma. In the context of the above findings, a pre-operative diagnosis of bladder leiomyoma was made. The patient consequently underwent a laparoscopic partial cystectomy. The resected bladder mass looked yellowish and well-demarcated, measuring 4.0 cm × 3.5 cm and infiltrated the muscular layer. The diagnosis of urinary bladder GCT was finally made by postoperative pathology, with positive immunohistochemical S-100 staining and negative pancytokeratin. The patient has been followed for 6 mo so far, with no tumor recurrence detected. Conclusion This case highlights the biological feature and differential diagnosis of urinary bladder GCT at the pathological and molecular levels. Transurethral resection of the bladder tumor and partial cystectomy are recommended in most urinary bladder GCT cases, while radical cystectomy is recommended in malignant cases.

The incidence of bladder leiomyoma is estimated at only 0.43% because most bladder tumors arise from the urothelium. Moreover, 30% of them are the extra-vesical type. The symptoms include urinary tract obstruction, bladder irritation, and dysuria, with the possibility of dyspareunia or hematuria depending on the size and location of the tumor. Bladder leiomyomas cannot be diagnosed solely by combining symptoms and imaging techniques. We present a rare case of giant sized extravesical-type bladder leiomyoma with a diameter of 15.5x14.5x14 cm, which was misdiagnosed as a uterine cervical leiomyoma. It caused unilateral ureteral distension without related symptoms. During the 8-year postoperative follow-up, the patient had two healthy full-term pregnancies and no recurrence was observed. We reviewed the literature of the most recent five years and discussed the characteristics of 22 bladder leiomyoma cases. Unlike the literature, the present case is unique due to the giant size of the bladder leiomyoma, its ureteral complications, and long follow-up period. Bladder leiomyomas are rare bladder tumors which should be borne in mind during the differential diagnosis of a pelvic mass. Surgical excision is the most useful procedure for diagnosis and treatment., Mesane leiomyomunun insidansı sadece %0,43 olarak tahmin edilmektedir; çünkü mesane tümörlerinin çoğu üroepitelyumdan kaynaklanmaktadır. Bunun yanı sıra, mesane leiomyomlarının sadece %30’u ekstra-vezikal tiptedir. Üriner sistem obstrüksiyonu, mesane irritasyonu, dizüri, disparoni veya hematüri gibi semptomlar kitlenin boyut ve yerine göre değişebilir. Yalnızca semptom ve görüntüleme tekniklerine dayanarak mesane leiomyomu tanısı konulamayabilmektedir. Preoperatif uterin servikal leiomyom ön tanısı düşünülen, 15,5x14,5x14 cm çapında tek taraflı üreteral distansiyona yol açan, nadir görülen bir ekstravezikal tip mesane leiomyomu olgusunu sunuyoruz. Sekiz yıllık postoperatif takip boyunca, hastanın iki sağlıklı term gebeliği mevcuttu ve nüks izlenmedi. Son beş yılın literatürü gözden geçirilerek 22 mesane leiomyomunun özellikleri sunuldu. Literatürden farklı olarak, mevcut olgu mesane leiomyomunun büyüklüğü, üreteral komplikasyonları ve uzun takip süresi ile benzersizdir. Mesane leiomyomları, pelvik kitlenin ayırıcı tanısında göz önünde tutulması gereken, nadir görülen mesane tümörleridir. Tanı ve tedavi için en faydalı prosedür cerrahi eksizyondur.

The incidence of mesenchymal bladder tumors is 1—5 %; of them, 0.43 % are bladder leiomyomas. The choice of treatment strategy primarily depends on the size and location of the tumor. Small endovesical leiomyomas can be removed by transurethral resection of the bladder, while in case of large (>5 cm) intramural or extravesical leiomyomas, laparoscopic resection is more effective. In this article, we report a case of large (>7 cm) bladder leiomyoma in a 28-year-old female patient. The patient has undergone laparoscopic resection of the bladder at P.A. Herzen Moscow Oncology Research Institute.

Benign neoplasms of the bladder are a rare pathology. Non-epithelial benign tumors of the bladder (fibromas, fibromyxomas, fibromyomas, hemangiomas, rhabdomyomas, leiomyomas, etc.) account for less than 0.5% of all that affect this organ. The analyzed literature describes about 250 cases of bladder leiomyoma. This article describes the clinical case of surgical treatment of bladder leiomyoma.

Introduction. Leiomyosarcoma is the most common benign tumor of the bladder. However, it is only a small percentage of all proliferative changes of this organ. Aim. Presentation based on two clinical cases of diagnostics and surgical treatment from laparoscopic access of bladder leiomyoma. Description of the cases. Case 1. The work contains a diagnosis based on transvaginal ultrasound (TVUS), cystoscopy and computed tomography (CT), as well as partial laparoscopic bladder re section of leiomyoma in young women. Case 2. The case of young women with the histopathological result confirmed bladder leiomyoma. Conclusions. Leiomyoma is a rare bladder cancer. Laparoscopic bladder resection is a safe method that leads to healing.

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.

Mesanenin benign mezenşimal lezyonları oldukça nadirdir ve tüm mesane tümörlerinin %1-5’inin oluştururlar. Bunların içinde de en sık leiomyoma saptanmaktadır. Benign lezyonlar radyolojik olarak maling kitleleri taklit etmesi nedeniyle klinik öneme sahiptir. Tanı radyolojik tetkiklerle kitlenin saptanması ve sonrasında yapılan cerrahi eksizyon ya da biyopsi ile histopatolojik olarak konulmaktadır. Ekstravezikal ve intramural form sistoskopik olarak saptanamayabilirken intravezikal leiomyomlar sistoskopi ile saptanabilir. Sistoskopi sırasında mesane içinde protrüde, kısmen düzgün sınırlı ve yüzeyi mesane mukozası ile kaplı lezyonlar görüldüğünde mesane leiomyomu ayırıcı tanıda düşünülmelidir. 44 yaşında kliniğimize irridatif semptomlarla tarafımıza başvuran ve mikroskopik hematüri saptanan erkek hastada mesanede 2x2 cm kitle saptandı. Minimal invaziv tedavi (TUR-mesane) sonrasında leiomyoma tanısı konulan vaka sunulmaktadır. Anahtar kelimeler: Leiomyom; mesane. Benign mesenchymal lesions of the bladder are very rare and constitute 1-5% of all bladder tumors. Among these, leiomyoma is the most common. Benign lesions are clinically important because they mimic radiologically malign masses. The diagnosis is made histopathologically by detecting the mass by radiological examinations and subsequent surgical excision or biopsy. Extravesical and intramural forms may not be detected cystoscopically, while intravesical leiomyomas can be detected by cystoscopy. Bladder leiomyoma should be considered in the differential diagnosis when protruding, partially smoothly bound and covered bladder mucosa lesions are observed during cystoscopy. A 44-year-old male patient who presented to our clinic with irridative symptoms and was found to have microscopic hematuria and 2x2 cm mass in the bladder. A case of leiomyoma diagnosed after minimally invasive treatment (TUR-bladder) is presented. © 2019, Duzce University Medical School. All rights reserved.

Benign tumor of the bladder (Leiomyoma) is a rare condition representing less than 0.5% of all bladder tumors. A 50-year-old female presented with asymptomatic hematuria for three months. Abdomen and pelvic magnetic resonance imaging (MRI) revealed a large intraluminal mass originating from the submucosal layer of the left anterolateral wall of the urinary bladder. An ultrasound-guided biopsy was performed, and a histopathological examination showed a spindle cell tumor. Cystoscopy revealed a massive indentation in the left posterolateral site of the urinary bladder extending to the bladder's dome. The patient underwent open partial cystectomy. At the follow-up, the patient was evaluated, and there was no hematuria or other complaints. Open partial cystectomy is the treatment of choice in an intramural tumor with an unfavorable position and difficulty in recognition.

Introduction: Leiomyoma of urinary bladder is a rare entity and comprises 0.43% of all bladder tumors. Here we present our series of 3 cases and the related review of literature.Methods: 3 cases of bladder leiomyoma presented over a period of 16 months in Osmania Medical College and Hospital. Detailed history was taken, physical examination, routine blood, urine and radiological investigations were done. Patients were treated by Trensurethral Resection (TUR) of the mass and histopathological analysis with Immunohistochemistry was done for all cases.Results: All 3 cases were females with mean age of 31.6 years. All cases were endovesical type, mass near bladder neck and presented with obstructive symptoms. Two cases presented with acute retention of urine. Radiological investigations in all patients suggested a possibility of leiomyoma and all cases had reduced urinary flow rates. Histopathology confirmed the diagnosis tin all cases. No recurrence was found at one year of follow up.Conclusion: Leiomyoma of urinary bladder is a rare disorder which frequently occurs in middle aged females. Symptoms are related to its size and location, diagnosis is confirmed by histopathological analysis. Treatment is by surgery (mainly TUR). Prognosis of the disease is excellent.

Introduction Bladder leiomyoma is a rare, benign tumor of the bladder. We present the first large endovesical leiomyoma case report in Indonesia and the largest bladder leiomyoma without any post-operation symptoms. Case presentation A 42-year-old female came with painless hematuria and irritative symptoms in the past year. Cystoscopy and open excision of the tumor showed well-encapsulated papillary solid mass at trigone (7 x 6.5 × 4 cm with a weight of 800 g). Postoperative histopathology confirmed the diagnosis of endovesical leiomyoma of the urinary bladder. Conclusion Open excision of bladder leiomyoma had good outcomes on large endovesical mass patients.

Bladder leiomyomas (BLs) are extremely rare benign tumors of mesenchymal origin. The exact pathophysiological mechanisms that lead to their appearance remain unclear including hormonal disorders, chromosomal abnormalities, and fetal remnants in the bladder. They usually remain asymptomatic for a long period of time. Solitary fibrous tumors (SFTs) are also rare neoplasms of mesenchymal origin with malignant potential usually affecting the pleura. The pathogenesis of SFTs remains unclear. We report the case of a 28-year-old male presenting with SFT of the pleura and synchronous BL. The patient presented with persistent cough as a sole symptom. Computed tomography (CT) of the thorax revealed a pleural mass, which was surgically removed and proved to be a SFT. At an early follow-up, abdominal CT scan revealed a bladder wall mass that proved to be a BL. This is the first report of BL with synchronous SFT of the pleura. Synchronous BLs and SFTs may be incidental, but the coexistence of two mesenchymal tumors at different sites, in a young patient, may raise the suspicion of a new clinical syndrome that warrants further investigation.

Objectives: To investigate the feasibility and initial surgical outcomes of transurethral enucleation for 6 patients with bladder leiomyoma. Materials: Six patients (mean age 50.2, range [34–67]) with bladder leiomyoma underwent transurethral enucleation. In each case, the resectoscope was inserted into the bladder. A resecting loop was used to incise the urothelium along the surgical margin of the bladder tumor, and a push was given through the resecting loop to further separate the tumor until it was shelled off the bladder wall. The intact mass was then cut into pieces and flushed out. After the operation, irrigation therapy was given. Results: Surgery was performed successfully in all 6 patients. The mean size of the tumor was 3.9 cm (1.8–6.7 cm). The mean operation time was 60 min (30–100 min). The mean follow-up period was 14.8 months (2–30 months), and no evidence of recurrence was found in all cases. Conclusion: Transurethral enucleation is a safe, reliable, and effective surgical technique for selected patients with well-encapsulated tumors and is well suited for further pathological diagnosis and radical treatment.

Bladder leiomyoma is a rare, benign tumour of the bladder. We present a clinical case of a 47-year-old asymptomatic woman with symptomatic bladder leiomyoma. Computed tomography showed well-defined bladder leiomyoma in the right posterior bladder wall. After partial cystectomy, pathology findings confirmed leiomyoma of bladder, and the patient achieved clinical recovery in 8 months. We discuss the relevant recent literature of bladder leiomyoma.

Leiomyomlar mesanenin nonepitelyal benign lezyonlari olup oldukca nadir olarak izlenmektedirler. Semptomatoloji olgular arasinda lezyonun buyuklugune, lokalizasyonuna ve karakterine gore oldukca farkliklar gostermektedir. Gunumuzde mesane leiomyomu icin optimal tedavi seceneginin konusundaki tartismalar devam etmektedir. Transuretral rezeksiyon, segmental cerrahi eksizyon veya parsiyel sistektomi ana tedavi yontemleri olarak gosterilmektedir. Bu calismada hematuri ile basvuran ve uygulanan transuretral rezeksiyon sonrasi doku tanisi leiomyom olarak sonuclanan 41 yasindaki erkek olgunun sunulmasi amaclanmistir.

Introductionand hypothesis Leiomyomas of the urinary bladder are rare tumors. Submucosal leiomyomas, when small and easily accessible, can be treated with transurethral resection, while unfavorably positioned or larger leiomyomas may be treated through an abdominal approach. In these cases, a laparoscopic approach for intravesical surgery is an alternative that may be considered. We aim to demonstrate a novel transvesical laparoscopic approach to bladder leiomyoma excision with a video. Methods A 45-year-old woman with urinary symptoms and a 40-mm submucosal bladder leiomyoma located at the interureteric ridge was referred to our hospital (tertiary referral hospital). Due to the location and size of the leiomyoma, and to increase the probability of complete resection, a transvesical laparoscopic approach was decided. A step-by-step video is presented to describe the surgical technique. Results There were no intra- or postoperative complications. The patient was discharged 48 h after the surgery. At 60 months' follow-up, the patient remains asymptomatic. Conclusions Transvesical laparoscopy may be considered for excision of bladder leiomyomas. This approach is feasible for trained surgeons as it requires a small working space.

Background: A bladder leiomyoma is a rare and benign bladder tumor. There are no established guidelines for the surgical treatment of this tumor. A transurethral approach for resection or surgical enucleation of the tumor is difficult, especially in patients with a large-sized leiomyoma. Therefore, a partial cystectomy is often indicated. In this case, we effectively performed a cystoscope-assisted laparoscopic enucleation of an intramural bladder leiomyoma. Case Presentation: A 46-year-old female was incidentally found to have a large tumor on the left wall of her urinary bladder. The MRI and needle biopsy results confirmed that the tumor was a bladder leiomyoma. Despite its benign nature, the tumor was found to progressively increase in size in 6 months. Therefore, we chose to perform a laparoscopic enucleation of the tumor. Simultaneous intraoperative cystoscopy was utilized to observe the operative area from within the bladder, thus enabling us to perform the procedure relatively safely. Although there was a minor inadvertent injury to the bladder mucosa intraoperatively, the left ureteral orifice was preserved. As a result, the tumor was effectively enucleated. The postoperative course was uneventful, and no recurrence was observed at the 4-month follow-up. Conclusion: We effectively accomplished the cystoscope-assisted laparoscopic enucleation of a large-sized leiomyoma of the urinary bladder. Based on our experience, we suggest that this combined technique is better and safer than an independent laparoscopic surgery. In addition, this surgery is now technically feasible and may have other applications in robotic surgery in the future.

Leiomyoma of the bladder is a very rare disorder that accounts for 0.43% of all bladder neoplasms. Although the pathophysiology of the bladder leiomyoma is unknown, there are some theories on it. The patients can be asymptomatic; when present, clinical symptoms (lower urinary tract symptoms and\or hematuria), are associated with tumor size and location. For diagnosis, imaging plays an important role: ultrasound, computed tomography (CT) scan and magnetic resonance imaging (MRI) are the examinations most frequently performed. Treatment consists of surgical removal of the tumor, and the prognosis is excellent.

Bladder leiomyoma is a rare benign neoplasm that may mimic a malignant lesion in medical images. We report a woman with bladder leiomyoma who was correctly diagnosed by contrast-enhanced ultrasound (CEUS). The patient was referred to our hospital after a bladder neoplasm was detected during a health checkup. CEUS showed fast wash-in and slow wash-out in the tumor, similar to a normal bladder wall. To conclude, bladder leiomyoma has its specific characteristics on CEUS, and this modality may be a good option for diagnosis of bladder leiomyoma.

18F-Fluorodeoxyglucose-positron emission tomography/computed tomography (18FDG PET/CT) has shown an increasing role in the evaluation of urinary bladder cancer, though benign pathological processes of the urinary bladder can also result in increased FDG uptake. Leiomyomas of urinary bladder are benign mesenchymal neoplasms and a very rare bladder tumor comprising

Neurofibromatosis Type 1 (Von Recklinghausen disease) is a common, autosomal dominant hereditary disorder characterized by involvement of multiple tissues derived from the neural crest. Urinary system involvement in neurofibromatosis is a rare condition. Leiomyoma of the bladder is a rare benign mesenchymal tumor. In this case, our experience and approach regarding the bladder leiomyoma development in a patient diagnosed with neurofibromatosis are presented and the literature data has been reviewed.

ResumenSe realiza la siguiente revisión de caso clínico de leiomioma vesical y literatura reportada, de manera que logremos ampliar nuestro conocimiento sobre diagnóstico y tratamiento, ya que su presentación es poco frecuente, representando menos del 1% de las neoplasias de vejiga, con mayor incidencia en mujeres en la quinta década de vida. La localización más común es endovesical y su etiología y patogénesis son aún inciertas. Clínicamente, pueden acompañarse de sintomatología urinaria irritativa; sin embargo, la mayoría de ellos son de diagnóstico incidental por su curso asintomático. El estudio histopatológico e inmunohistoquímico son indispensables para el diagnóstico definitivo.Paciente femenino de 34 años de edad, con diagnóstico histopatológico de carcinoma urotelial in situ, quien acude a nuestro centro por segunda valoración médica; se revisan los estudios de imagen y se determina la discrepancia con reporte histopatológico, por lo que se solicita revisión de laminillas reportando leiomioma vesical.En este caso clínico destaca la importancia del diagnóstico histopatológico definitivo y su correlación con los estudios de imagen para proporcionar al paciente la mejor opción terapéutica. Debido a su presentación extremadamente rara, su diagnóstico y sospecha clínica son aún un reto para el urólogo y el patólogo.AbstractThrough the report of the following clinical case of bladder leiomyoma and the literature review, we were able to broaden our knowledge in relation to the diagnosis and treatment of this pathology; it is an infrequent disease, representing less than 1% of bladder neoplasias, with a greater incidence in women in their fifth decade of life. It is most commonly intravesical and its etiology and pathogenesis are still uncertain. It can clinically manifest with irritative urinary symptomatology, but the majority of cases are asymptomatic and thus diagnosed incidentally. Histopathologic and immunohistochemistry studies are essential for making the definitive diagnosis.A 34-year-old woman had a histopathologic diagnosis of urothelial carcinoma in situ and came to our center for a second medical opinion. A discrepancy was observed between the imaging studies and the histopathologic report, and after reviewing the slides, bladder leiomyoma was determined.This case underlines the utmost importance of the correlation between the definitive histopathologic diagnosis and the imaging studies for offering the patient the best therapeutic option. Due to the extremely rare presentation of bladder leiomyoma, its clinical suspicion and diagnosis continue to be a challenge for both the urologist and the pathologist.

A 64-year-old male patient with a large pelvic mass and a right renal mass was referred to our facility. The patient underwent a right radical nephrectomy and pelvic mass excision. A histopathological examination led to a diagnosis of renal oncocytoma and urinary bladder leiomyoma.

Highlights • Only about 250 cases of bladder leiomyoma reported in English literature. • This is the first reported case to present in acute manner as a case of febrile UTI. • Imaging is mandatory to diagnose the underlying cause of febrile UTI. • Though benign, failure to diagnose the lesion may lead to recurrence of severe UTI., Introduction Leiomyomas of urinary bladder constitute only about 0.43% of all bladder tumors. Only about 250 cases were reported in English literature. This is the first reported case of bladder leiomyoma to present with febrile urinary tract infection. Case presentation We report a case of a 37- year old male who presented with febrile urinary tract infection. Imaging showed a bladder lesion. This lesion was managed by transurethral resection. Pathologic diagnosis was bladder leiomyoma. Discussion Although bladder leiomyomas are benign, they can cause serious sequelae, including serious urinary tract infections as the case we present here shows. This is why it is important to early diagnose and treat this condition. Conclusion This case highlights the importance of early introduction of imaging in patients presenting with severe urinary tract infections. Failure to diagnose this lesion as the underlying cause of infection may have easily led to recurrence of similar severe life-threatening infections.