Adult bladder rhabdomyosarcoma
Rhabdomyosarcomas (RMS) are mesenchymal tumors that develop at the expense of striated muscle fibers. A 72-year-old patient, diabetic, hypertensive, smoker, who consulted for terminal hematuria evolving for one year. There was no notion of professional exposure to aromatic amines or pelvic irradiation. Ultrasound of the urinary tract showed a 9 cm × 7 cm bladder tissular formation with dilatation of the right pyelocaliceal cavities. Cystoscopy showed a bulging tumor with a wide implantation base involving the trigone and the right wall infiltrating the right ureteral orifice. They performed a transurethral resection of the bladder. The histological analysis of the resection chips showed a malignant sarcomatous proliferation of rounded and sometimes spindle-shaped cells. There were rhabdomyoblasts characterized by moderate nuclear atypia with sparse and sometimes banded cytoplasm. Mitoses were rare; the stroma was sparse and vascular. Immunohistochemistry was negative for Desmin and positive for myogenin. CT scan showed a tumor of the posterior wall of the bladder with the invasion of the perivesical fat. There was a right ureterohydronephrosis and pulmonary metastasis. He received carboplatin-based chemotherapy. After three months, the patient died with multi-visceral failure.