[Retrovesical leiomyosarcoma responsive to preoperative chemoradiotherapy: a case report]

Area of Science:

• Oncology
• Urology
• Radiotherapy

Background:

• Retrovesical tumors are rare and can present diagnostic challenges.
• Leiomyosarcoma is an uncommon soft tissue sarcoma that can occur in the retrovesical space.
• Multimodality treatment is often necessary for managing large retrovesical tumors.

Observation:

• A 70-year-old male presented with dysuria and was diagnosed with a large retrovesical solid tumor.
• Imaging studies (CT and MRI) confirmed the tumor's size and location.
• Transurethral needle biopsy identified the tumor as leiomyosarcoma.

Findings:

• Neoadjuvant intraarterial chemotherapy (cisplatin, methotrexate, pirarubicin) combined with radiotherapy (40 Gy) significantly reduced tumor size.
• Surgical extirpation was successfully performed following neoadjuvant treatment.
• Postoperative assessment revealed no infiltration into adjacent organs or lymph node metastasis.

Implications:

• This case highlights the efficacy of neoadjuvant intraarterial chemotherapy and radiotherapy for retrovesical leiomyosarcoma.
• A combined treatment approach can facilitate complete surgical resection of challenging retrovesical tumors.
• Successful management led to a 12-month recurrence-free survival, suggesting a favorable prognosis with this strategy.