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Urinary bladder leiomyosarcoma with osteoclast-like multinucleated giant cells: a case report
Vincenzo Fiorentino1,2, Francesco Pierconti1,2, Niccolò Lenci3
1Servizio di Istopatologia e Citodiagnosi, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy.
BMC Cancer
|August 4, 2019
Summary
This study reports a rare bladder leiomyosarcoma case featuring osteoclast-like giant cells (OGCs). These OGCs, initially confounding diagnosis, were found to be reactive and non-neoplastic.
Area of Science:
- Uropathology
- Oncology
- Surgical Pathology
Background:
- Bladder leiomyosarcoma is the most common bladder mesenchymal neoplasm.
- Its rarity and complex morphology can complicate differential diagnosis.
Observation:
- A case of an 86-year-old male with a 3.5 cm bladder tumor initially diagnosed as low-grade urothelial neoplasia.
- Histological examination revealed a leiomyosarcoma with spindle cells, muscular wall invasion, and numerous osteoclast-like giant cells (OGCs).
Findings:
- The leiomyosarcoma exhibited a complex pattern with spindle cell proliferation and invasion.
- Osteoclast-like giant cells (OGCs) were a prominent feature within the tumor.
- Immunohistochemical analysis indicated that the OGCs were of non-neoplastic origin, likely reactive histiocyte/macrophage differentiation.
Implications:
- The presence of OGCs can mimic other pathologies, posing diagnostic challenges in bladder tumors.
- The OGCs in this leiomyosarcoma case are considered reactive, not neoplastic.
- Further research is needed to elucidate the precise role of OGCs in urinary bladder tumors, particularly leiomyosarcomas.
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