Yavuz Onur DANACIOĞLU, Burçin Rabia GİRGİN, Ferhat KESER, Asıf YILDIRIM

Mesanenin Sarkomatoid Karsinom Varyant Histolojisi: Olgu Serisi ve Literatür Değerlendirmesi

Amaç: Agresif seyirli olan sarkomatoid ürotelyal karsinomlar, diğer ürotelyal kanser tiplerine göre daha kötü prognoza, daha ileri evreye ve daha fazla oranda metastaz riskine sahiptirler. Bu çalışmada mesanenin sarkomatoid ürotelyal karsinomu tanısı alan 10 hastanın klinik ve histopatolojik sonuçları literatür eşliğinde sunulacaktır. Gereç ve Yöntemler: Çalışmaya Kasım 2012 ve Aralık 2018 tarihleri arasında histopatolojik olarak sarkomatoid karsinom tanısı alan 10 hasta dahil edildi. Hastaların demografik özellikleri ve patoloji sonuçları retrospektif olarak değerlendirildi. Hastalar ameliyat öncesi ayrıntılı öykü, fiziksel inceleme, rutin biyokimyasal ve hematolojik tetkikler, üriner ultrasonografi, abdominopelvik tomografi, akciğer grafileri ve sistoskopi ile değerlendirildiler. Bulgular: Hastaların ortalama yaşı ve ortalama takip süreleri sırası ile 70,2 (51-81) yıl ve 9,2 (2-18) ay olarak saptandı. Hastaların başvuru şikayetlerinin makroskopik hematüri olduğu gözlendi. Altı (%60) hastaya radikal sistektomi ameliyatı uygulandı. Bir hasta neoadjuvan kemoterapi aldı. Radikal sistektomi sonrasında 1 (%16,6) hastada evre pT2b tümör, 3 (%50) hastada evre pT3 tümör ve 2 (%33,3) hastada evre pT4 tümörün olduğu görüldü. Üç (%50) hastanın N1 olduğu görüldü ve üç (%50) hastada eşlik eden CIS varlığı saptandı. Lenf nodu tutulumu açısından 3 (%50) hastada metastaz mevcuttu. Yapılan takiplerde 6 (%60) hastada hastalığa bağlı ölüm görülürken, 4 (%40) hasta halen takip edilmektedir. Sonuç: Mesanenin sarkomatoid karsinomları genelde agresif seyretmekte ve hastalar ileri evre tümörle tarafımıza başvurmaktadırlar. Radikal cerrahi tedaviye karşın bu tür tümörlerin erken nüks ve progresyon göstereceği göz önünde bulundurularak bu hastaların yakın takip edilmeleri gerekmektedir

Sarcomatoid Carcinoma, a Variant Histology of the Bladder: Case Series and Literature Review

Objective: Sarcomatoid urothelial carcinoma has an aggressive nature; a worse prognosis, a more advanced stage and a greater risk of metastasis than other types of urothelial cancers. In this study, the clinical and histopathological results of 10 patients with sarcomatoid urothelial carcinoma of the bladder will be presented and the current literature will be reviewed. Material and Methods: The study included 10 patients histopathologically diagnosed as sarcomatoid carcinoma between November 2012 and December 2018. Demographic characteristics and pathology results were evaluated retrospectively. Patients were evaluated with detailed history, physical examination, routine biochemical and hematological examination, urinary ultrasonography, abdominopelvic tomography, chest radiography and cystoscopy before surgery. Results: The mean age and mean followup period of the patients were 70.2 (51-81) years and 9.2 (2-18) months respectively. The mean symptom of the patients was macroscopic hematuria. Six (60%) patients underwent radical cystectomy. One patient received neoadjuvant chemotherapy. One (16.6%) patient had a stage of pT2b tumor, three (50%) patients had a stage of pT3 tumor and two (33.3%) patients had a stage of pT4 tumor after radical cystectomy. Three (50%) patients were found to have N1 disease and three (50%) patients had coexisting carcinoma in situ (CIS). Metastasis for lymph node involvement was present in three (50%) of the patients. Six (60%) patients have died due to disease, four (40%) patients are still continued to follow up. Conclusion: Sarcomatoid carcinoma of the bladder is usually an aggressive tumor and patients are referred with advanced stages. Despite radical surgery, these patients should be followed up closely as early recurrence and progression can be seen.

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