Sarcomatoid Urothelial Carcinoma of the Bladder: A Case Report and Review of Literature

Abstract

Background: Urothelial carcinoma is the most common type of bladder tumour accounting for 95–98% of all bladder tumours. It has different variants, including the sarcomatoid type. Sarcomatoid urothelial carcinoma (SUC) is a very rare variant of urothelial carcinoma presenting as a biphasic malignancy with epithelial and mesenchymal components. SUC accounts for 0.31% of all bladder tumours and is often aggressive with a poor prognosis. Patients are mostly treated by cystectomy followed by adjuvant chemotherapy and radiotherapy. Case Presentation: In this paper, we report a case of sarcomatoid carcinoma in a 40-year old male who presented with a 2-year history of intermittent painless hematuria and lower abdominal pain. Abdomino-pelvic ultrasound and cystoscopy revealed a mass over the dome of the bladder. He underwent transurethral surgical resection of the bladder mass. The patient did well postoperatively, was discharged 6 days after the procedure, and was asked to come back for a follow up in 2 weeks. When he came, he was found to be improving and was counselled on the plan for chemotherapy and radiotherapy, but he never came back to the clinic again after he left. Conclusion: Sarcomatoid carcinoma of the bladder is a rare variant of urothelial carcinoma characterized by a combination of malignant epithelial and mesenchymal components. Its treatment modalities include surgery, radiotherapy, and/or chemotherapy.