Bladder sarcoma treated with radical cystectomy and adjuvant epirubicin and ifosfamide chemotherapy: a case report

Bladder sarcoma is a rare mesenchymal tumor of the bladder, accounting for approximately 0.3% of all bladder tumors. Due to its low incidence and the lack of specificity in clinical symptoms and imaging findings, preoperative diagnosis is difficult. This article reports a case of a 53-year-old male patient who presented with painless gross hematuria. Ultrasound and computed tomography (CT) indicated a space-occupying lesion in the bladder. Cystoscopic biopsy indicated a malignant tumor, likely undifferentiated carcinoma or poorly differentiated sarcoma. The patient underwent laparoscopic radical cystectomy with pelvic lymph node dissection, ileal conduit, and appendectomy. Postoperative pathological examination, combined with immunohistochemical results, was considered to be a small round cell undifferentiated sarcoma. The patient received six cycles of adjuvant chemotherapy with epirubicin and ifosfamide (EI) after surgery. At the 12-month follow-up, the patient showed no evidence of tumor recurrence or distant metastasis. Currently, bladder sarcoma is clinically rare, and its pathogenesis remains poorly understood. Previous literature mostly consists of case reports, and there is a lack of unified treatment standards. The effectiveness of treatment methods still requires validation through more cases. This case report details the entire diagnosis and treatment process of a patient with bladder sarcoma, demonstrating the feasibility and short-term efficacy of radical surgery combined with the EI chemotherapy regimen, and provides a reference for the clinical diagnosis and treatment of such rare cases.