SARCOMATOID CARCINOMA OF THE URINARY BLADDER

Introduction: Most of bladder tumors are urothelial cell carcinomas. Sarcomatoid carcinoma is a rare tumor of the urinary bladder and accounts for approximately 0.3% of all bladder malignancies. In these tumors, histogenesis and biological behavior remain controversial. Herein, we report five cases of sarcomatoid carcinoma of the urinary bladder. Materials and Methods: Between January 1998 and January 2003 a total of 5 patients with sarcomatoid carcinoma of the bladder were evaluated retrospectively. Preoperatively all patients evaluated with physical examination, routine hematologic analysis, urinary ultrasonography and computerized tomography. Results: Radical cystectomy was performed in 159 invasive bladder cancer patients in our department and of these, 5 (0.031%) were sarcomatoid carcinoma of the bladder. The mean age and mean follow-up period were 67.8 (range: 59-79) years and 13.4 (range: 6-19) months, respectively. At the time of diagnosis the tumors were staged as T3b in 3 cases, T3a in one case and T2 in one case. Primary therapy consisted of radical cystectomy in all cases. Four of 5 the tumors were macroscopically polypoid. Remaining one patient had a solitary tumor. All patients died of progressive primary disease. Conclusion: Our study shows that sarcomatoid carcinoma of the urinary bladder is aggressive and the overall prognosis of this tumor is very poor. Early diagnosis and radical surgery are the only options available to increase life expectancy for these patients. But poor prognosis and short survival time of these patients should be kept in mind despite radical surgical approaches.