Massive XXXX arising from the bladder serosa: a case report.

@entity1 @entity82 @entity353 @entity39 @entity5 @entity2460
INTRODUCTION: @entity2460 are rare @entity5 of mesenchymal origin. They are often of low malignant potential and rarely metastasize. While they frequently arise from the pleura, they can occur at any soft tissue site in the body. We present a case of a large (28 * 21cm) @entity2460 arising from the bladder serosa. In addition, the clinicopathologic features, differential diagnosis, cytogenetics and management of this rare disease are discussed, along with a review of the existing literature on this topic. CASE PRESENTATION: An otherwise healthy 41-year-old Caucasian @entity1 presented with @entity353 and progressive abdominal bloating. A subsequent computed tomography scan of his chest, abdomen and pelvis revealed a 26.8 * 21cm intra-abdominal mass occupying most of his abdominal cavity. The inferior vena cava was compressed, and the mass extended inferiorly to his upper pelvis abutting the superior dome of his bladder. He underwent operative resection and the resected mass measured 28 * 21 * 18cm and weighed 4.8kg. The cut surface revealed a gray-white mass with an ill-defined whorled-like pattern, with randomly assorted tan fleshy nodules. A histologic evaluation revealed variable, alternating hypercellular and hypocellular areas, with areas of @entity39 . The @entity5 cells varied from spindle to epithelioid within a hyalinized stroma. In the hypercellular areas, the @entity5 cells showed moderate atypia with high mitotic activity. The histological features combined with immunophenotyping were suggestive of a @entity2460 that grossly appeared to be growing from the bladder serosa, specifically the intraperitoneal superior dome of the bladder. Our @entity1 is currently eight months post-surgery without evidence of recurrence. CONCLUSIONS: Extrapleural occurrences of solitary @entity82 are being increasingly observed. @entity5 of the urinary bladder, however, are very rare. As there are no pathognomonic features of @entity5 , surgical resection is often both diagnostic and therapeutic, as was the case in our report.
