Sarcomas are very rare in the urinary tract. Many patients referred to our institution with tumors diagnosed as sarcomas of arriving at epithelial components in the review, and therefore are best classified as carcinomas, as described above. However, sarcomas that appear to arise within the bladder without a detectable epithelial component occur. In our opinion, radiotherapy is the only recognized risk factor, and the typical delay of two or three decades of exposure to radiation of secondary cancer seems to apply.
In adults, the most common histological subtype is leiomyosarcoma, but in our own record, osteogenic sarcoma is the most common. Of course, many tumors show areas with more than one pattern of differentiation. Apart from the setting of prior pelvic radiation, no features of clinical presentation. It is our impression that patients with sarcoma are more susceptible to tumor implantation in the urethra after transurethral resection (TUR), but this has not been formally studied or reported by other centers. Clinical management follows the principles of sarcoma management in other sites. In general, surgery is the mainstay of therapy. If the primary tumor is quite large, and shows that histology may be a reasonable response to chemotherapy provided (such as osteogenic sarcoma), then, neoadjuvant chemotherapy is administered. As expected, the result is driven largely by the stage.
In adults, the most common histological subtype is leiomyosarcoma, but in our own record, osteogenic sarcoma is the most common. Of course, many tumors show areas with more than one pattern of differentiation. Apart from the setting of prior pelvic radiation, no features of clinical presentation. It is our impression that patients with sarcoma are more susceptible to tumor implantation in the urethra after transurethral resection (TUR), but this has not been formally studied or reported by other centers. Clinical management follows the principles of sarcoma management in other sites. In general, surgery is the mainstay of therapy. If the primary tumor is quite large, and shows that histology may be a reasonable response to chemotherapy provided (such as osteogenic sarcoma), then, neoadjuvant chemotherapy is administered. As expected, the result is driven largely by the stage.