Carcinosarcoma of the urinary bladder--case report and literature review

We describe a patient who presented with gross haematuria and dysuria. Investigations confirmed a bladder tumour, for which transurethral resection was done. The histology showed a carcinosarcoma, which was muscle invasive but organ-confined. The patient refused radical surgery and underwent a course of radical radiotherapy. He died 14 months later. Carcinosarcoma of the urinary bladder is a rare, mixed malignant tumour, composed of mesenchymal and epithelial elements. It is commoner in elderly men. It is an aggressive tumour with a short clinical course, and must be distinguished from collision tumours and spindle cell tumours. Immunohistochemical stains are useful in its diagnosis. It is probably best managed by radical surgery with or without adjuvant therapy, but because of the small number of incidences reported, there is no universal agreement on its therapy.