Bladder PEComa: A case report and literature review.

Area of Science:

• Urologic Oncology
• Diagnostic Imaging
• Pathology

Background:

• Perivascular epithelioid cell tumors (PEComas) are rare mesenchymal neoplasms.
• Bladder PEComas are exceptionally uncommon, posing diagnostic challenges.

Observation:

• Computed tomography (CT) is crucial for characterizing bladder PEComas.
• Typical CT findings include large (≥5 cm), round, elliptical, or irregular cystic masses.
• Clear tumor margins and significant enhancement of solid components are observed.

Findings:

• Enhanced vascularity, including feeding arteries and draining veins, is a key CT feature.
• The solid portions of bladder PEComas demonstrate marked enhancement post-contrast.
• Distinguishing PEComas from other bladder neoplasms preoperatively is difficult due to overlapping imaging features.

Implications:

• Accurate preoperative diagnosis of bladder PEComa can improve surgical planning and patient outcomes.
• Radiologists and urologists should be aware of the characteristic CT appearance of bladder PEComa.
• Further research into advanced imaging techniques may enhance diagnostic accuracy for rare bladder tumors.