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Sarcomatoid Carcinoma of Urinary Bladder: a Case Report
Garima Daga1, Prashant Kerkar1
1Department of Surgical Oncology, Bombay Hospital, Bombay Hospital Marg, Marine Drive, Mumbai, 400020 India.
Indian Journal of Surgical Oncology
|December 13, 2018
Summary
Sarcomatoid carcinoma, a rare and aggressive bladder tumor, presents diagnostic challenges. Immunohistochemistry is crucial for accurate diagnosis and guiding patient management.
Area of Science:
- Uro-oncology
- Pathology
- Diagnostic Imaging
Background:
- Sarcomatoid carcinoma is an exceptionally rare variant of urothelial carcinoma, accounting for approximately 0.3% of primary bladder tumors.
- This aggressive tumor type is associated with a poor prognosis and can be diagnostically challenging.
Observation:
- A 65-year-old male presented with obstructive voiding symptoms and hematuria, revealing a 35x45 mm bladder mass with perivesical fat infiltration on MRI.
- Initial histopathology suggested a high-grade spindle cell tumor, with differential diagnoses including sarcomatoid carcinoma and pleomorphic sarcoma.
Findings:
- Immunohistochemistry (IHC) confirmed the diagnosis of sarcomatoid carcinoma, showing positivity for cytokeratin (CK 8/18) and GATA 3.
- The final pathological staging was pT2, N0, Mx, with all pelvic lymph nodes negative for metastasis.
Implications:
- Accurate and timely diagnosis of rare bladder cancer variants like sarcomatoid carcinoma is essential for appropriate treatment planning.
- Immunohistochemistry is a critical tool in differentiating sarcomatoid carcinoma from other spindle cell tumors, significantly impacting patient prognosis and management strategies.
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