[Carcinoma of the bladder with pseudosarcomatous stroma. Presentation of a case]

Carcinoma with pseudosarcomatous stroma of the bladder. Case report. We report a case of transitional cells carcinoma of urinary bladder with pseudosarcomatous stroma in a 54 years old male. The patient was admitted in hospital owing to recidivous haematuria events for about 3 months. Three urine samples were sent for cytological studies that showed the presence of transitional neoplastic cells. Subjected to a cystoscopic examination the patient revealed a roundish peduncled bladder formation of about 3.5 cm. in size. Hence three bladder lesion biopsies were done. The histological sections obtained pointed out the existence of two cellular populations: the first one presented roundish or lengthened, pluristratified cells arranged in solid nests, with transitional morfology and high atypias; the other population had sarcomatoid features characterized by lenghtened cells with hyperchromic nuclei. The two populations were mixed up and there were sometimes carcinomatous areas that merged into sarcomatoid areas. Chondroid areas were also observed. We diagnosed a G3 transitional cells carcinoma with pseudosarcomatous stroma. The lesion, after literature review, results to be somewhat rare and not easily interpretable since it may be confused with carcinosarcoma. The rarity of this case and the problems of differential diagnosis connected with it urged us to this pubblication along with a short review of literature.