Leimyosarcoma of the urinary bladder. 13 years after cyclophosphamide therapy for Hodgkin's disease

A leiomyosarcoma of the urinary bladder occurred in a 17-year-old boy who was treated with a total dose of 67 g cyclophosphamide over a period of 5 years for Hodgkin's disease diagnosed at the age of 4. Cyclophosphamide was discontinued at the age of 9 because of gross hematuria, and intermittent hematuria recurred 8 years after (at the age of 17) the cessation of this drug. A large exophytic tumor found in the urinary bladder was diagnosed as leiomyosarcoma by light and electron microscopic studies. In addition, there were microscopic features of long-term cyclophosphamide toxicity throughout the bladder wall.