Clinics in diagnostic imaging (50). Leiomyosarcoma of bladder

A 39-year-old man presented with intermittent painless macroscopic haematuria. He was subsequently diagnosed to have a high grade leiomyosarcoma of the bladder. He underwent total cystoprostatectomy and radiotherapy but died of metastatic disease five months after the initial diagnosis. Aspects of the imaging and diagnostic pathway of painless haematuria are discussed. The management of leiomyosarcomas in the urinary system is highlighted.