Rhabdomyosarcoma of the Urinary Bladder and Prostate in Adults: A Clinicopathologic Study of 11 Cases
M Liang, P Troncoso, BA Czerniak, CC Guo. UT MD Anderson Cancer Center, Houston, TX
Background: Rhabdomyosarcoma (RMS) of the urinary bladder and prostate is a rare tumor which occurs predominantly in children. There is limited information about this tumor in adults.
Design: We retrospectively searched our pathology file from 1980-2008 and identified 11 adult patients with rhabdomyosarcoma of the urinary bladder and prostate. Patients with previous history of carcinoma of the bladder or prostate were excluded from the study. The histology slides including immunohistochemical staining slides were reviewed. The clinical information was collected from patients' medical records.
Results: The average age of patients was 35 years (range, 18-60 years). The most common presenting symptom was urinary outlet obstruction (n=6), followed by pelvic pain (n=2), hematuria (n=2) and dysuria (n=1). All 11 patients had biopsies of the bladder or prostate. The biopsies showed embryonal type RMS in 8 cases, and non-classified RMS in 3 cases. The immunohistochemical stains showed that the tumor cells were positive for desmin in all cases. In addition, the tumor cells were also positive for myogenin (2 of 4 cases) and myoD1 (1 of 3 cases). Four patients received cystoprostatectomy and 1 patient had radical prostatectomy. In these resection specimens, the average size of tumor was 6.5 cm (range 4.5 to 10.0 cm), and the tumor extensively involved the bladder and prostate with positive resection margin in 2 cases. Followup information was available for 8 patients with an average period of 17 months (range, 3-34 months). The patients had received chemotherapy (n=7), radiation therapy (n=6), and surgery (n=5). Six patients died of disease at an average of 20 months (range, 3-34 months) and 2 patients were alive with disease at 7 and 10 month, respectively.
Conclusions: RMS of the urinary bladder and prostate is a highly aggressive disease in adults with extensive involvement of the bladder and prostate. Embryonal RMS is the most common histologic type in adults. This disease carries a poor prognosis despite multiple-modality therapy.
Category: Genitourinary (including renal tumors)
Wednesday, March 11, 2009 9:30 AM
Poster Session V # 105, Wednesday Morning