[Spindle cell carcinoma of the urinary bladder: a case report]

A 74-year-old man with spindle cell carcinoma of the urinary bladder is reported. He presented to our clinic with gross hematuria resulting in bladder tamponade. Transurethral resection (TUR) was performed in order to control severe hematuria intractable with conservative therapy. Histologically the tumor invaded the muscle layer and was composed of two components, small foci of transitional cell carcinoma and numerous spindle cells with severe atypia and then the transition was recognized between them. Immunohistochemically transitional cell carcinoma was intensely positive for cytokeratin (CK) and epithelial membrane antigen (EMA), but negative for vimentin (VIM). Moreover some parts of spindle cells were weakly stained for CK and EMA. Three months after TUR, multiple pulmonary metastases and moderate right hydronephrosis occurred and he died of respiratory insufficiency one month later.