Objective: To summarize the experience in the diagnosis and treatment of non-epithelial tissue tumor of urinary bladder.
Methods: >From 1953 to April 2002, a total of 28 patients with non-epithelial tissue tumor in 3 925 bladder tumor cases were analyzed.
Results: Painless gross hematuria, pelvic mass, urinary frequency and dysuria are symptoms of non-epithelial bladder tumor. Ultrasonic examination, computed tomography (CT) scan, cystoscopy and biopsy is used for diagnosis of the tumor. Seventeen of 28 patients (61.7%) were malignant neoplasms in 7 kinds of pathologic types, which was small cell carcinoma (5 cases), rhabdomyosarcoma (4 cases), leiomyosarcoma (4 cases), lymphoma (1 case), malignant fibrous histiocytoma (1 case), liposarcoma(1 case), melanoma (1 case) respectively. Eleven of 28 patients (39.3%) were benign tumors with 4 kinds of histologic types including 2 cases of cavernous hemangioma, 1 case of fibroma, 1 case of leiomyoma, 7 cases of pheochromocytoma. All benign tumor patients were treated with partial cystectomy, transurethral bladder tumor resect (TURBT) and fulguration. In 17 malignant neoplasms patients, 7 of them received partial cystectomy, 9 received radical cystectomy, and 1 patient's tumor was unresectable. Those malignant bladder tumor patient are followed up, but 3 years survival rates is only 8/17.
Conclusions: Non-epithelial tissue tumor of the urinary bladder is rare with complicated pathologic types. Malignant neoplasms are more than benign tumors with very poor prognosis, benign tumors' prognosis is good. Diagnosis rate which was confirmed before operation is low. Dip biopsy under cystoscopy may enhance the diagnosis rate. Surgical treatment is the main therapy for non-epithelial tissue tumor of the urinary bladder. Because of the aggressive biologic behavior of malignant tumors, they should be identified promptly and treated appropriately. According to the histologic appearance radiotherapy and chemotherapy is mandatory in some cases.