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[Malignant mesodermal mixed tumor of the bladder--report of a case].

Takeshi Kurozumi, Hiroo Yagi, Tetsuo Omoto and Yasushi Iwata° Department of Urology, Kyushu Koseinenkin Hospital 1) Department of Pathology A 66-years-old man with a malignant mesodermal mixed tumor of the bladder was reported. A large bulky pedunculated mass was located in the left side of the bladder. Adjacent to the stalk of the tumor, a non-papillary invasive tumor was present involving the left intramural ureter. Tumor mapping by step sections of the resected bladder revealed that the non-papillary invasive tumor was composed of transitional cell carcinoma (G3) associated with dysplasia or carcinoma in situ in the periphery, and extended directly to the surface of the stalk of bulky mass. The large bulky mass was composed of carcinomatous and sarcomatous elements. The former consisted mainly of transitional cell carcinoma and adenocarcinoma with occasional foci of squamous metaplasia, while the latter consisted of chondrosarcoma, osteosarcoma, giant cell tumor and non-differentiated malignant spindle cell component. Unfortunately, the patient died 8 months after the total cystectomy followed by adjuvant chemotherapy. Autopsy finding showed tumor embolism of the lung and extensive bone marrow metastasis which consisted of transitional cell carcinoma. Our case may suggest an epithelial origin of this tumor giving rise to metaplastic mesodermal proliferation, which was recently proposed by Koss as"sarcomatoid carcinoma".