TY - JOUR T1 - Sarcomatoid Carcinoma, a Variant Histology of the Bladder: Case Series and Literature Review TT - Mesanenin Sarkomatoid Karsinom Varyant Histolojisi: Olgu Serisi ve Lliteratür Değerlendirmesi AU - Danacıoğlu, Yavuz Onur AU - Girgin, Rabia Burçin AU - Keser, Ferhat AU - Yıldırım, Asıf PY - 2019 DA - October DO - 10.33719/yud.524193 JF - Yeni Üroloji Dergisi JO - New J Urol. PB - Ali İhsan TAŞÇI WT - DergiPark SN - 1305-2489 SP - 182 EP - 188 VL - 14 IS - 3 LA - en AB - Objective: Sarcomatoid urothelial carcinomahas an aggressive nature; a worse prognosis,a more advanced stage and a greaterrisk of metastasis than other types of urothelialcancers. In this study, the clinical andhistopathological results of 10 patients withsarcomatoid urothelial carcinoma of the bladderwill be presented and the current literaturewill be reviewed.Material and Methods: The study included10 patients histopathologically diagnosedas sarcomatoid carcinoma between November2012 and December 2018. Demographic characteristicsand pathology results were evaluatedretrospectively. Patients were evaluatedwith detailed history, physical examination,routine biochemical and hematological examination,urinary ultrasonography, abdominopelvictomography, chest radiography andcystoscopy before surgery.Results: The mean age and mean followupperiod of the patients were 70.2 (51-81)years and 9.2 (2-18) months respectively. Themean symptom of the patients was macroscopichematuria. Six (60%) patients underwentradical cystectomy. One patient received neoadjuvantchemotherapy. One (16.6%) patienthad a stage of pT2b tumor, three (50%) patientshad a stage of pT3 tumor and two (33.3%)patients had a stage of pT4 tumor after radicalcystectomy. Three (50%) patients were found to have N1 diseaseand 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 usuallyan aggressive tumor and patients are referred with advanced stages.Despite radical surgery, these patients should be followed up closelyas early recurrence and progression can be seen. KW - Bladder cancer KW - sarcomatoid carcinoma KW - variant histology N2 - Amaç:Agresif seyirli olan sarkomatoid ürotelyal karsinomlar,diğer ürotelyal kanser tiplerine göre daha kötü prognoza, daha ileri evreye vedaha fazla oranda metastaz riskine sahiptirler. Bu çalışmada mesanenin sarkomatoidürotelyal karsinomu tanısı alan 10 hastanın klinik ve histopatolojik sonuçlarıliteratür eşliğinde sunulacaktır.Materyalve Metod:Çalışmaya Kasım 2012 ve Aralık 2018 tarihleri arasındahistopatolojik olarak sarkomatoid karsinom tanısı alan 10 hasta dahil edildi.Hastaların demografik özellikleri ve patoloji sonuçları retrospektif olarakdeğerlendirildi. Hastalarameliyat öncesi ayrıntılı öykü, fiziksel inceleme, rutin biyokimyasal vehematolojik tetkikler, üriner ultrasonografi, abdominopelvik tomografi, akciğergrafileri ve sistoskopi ile değerlendirildiler.Bulgular:Hastaların ortalama yaşı ve ortalamatakip süreleri sırası ile 70,2 (51-81) yıl ve 9,2(2-18) ay olarak saptandı. Hastaların başvuruşikayetlerinin makroskopik hematüri olduğu gözlendi. Altı (%50) hastaya radikalsistektomi ameliyatı uygulandı. Bir hasta neoadjuvan kemoterapi aldı. Radikalsistektomi 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 veüç (%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 halentakip edilmektedir.Sonuç:Mesanenin sarkomatoid karsinomlarıgenelde agresif seyretmekte ve hastalar ileri evre tümörle tarafımızabaşvurmaktadırlar. Radikal cerrahi tedaviye karşın bu tür tümörlerin erken nüksve progresyon göstereceği göz önünde bulundurularak bu hastaların yakın takipedilmeleri gerekmektedir. CR - 1. Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C. GLOBOCAN 2012 v1. 0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Lyon: IARC. 2013. CR - 2. Reisz PA, Laviana AA, Chang SS. Management of High-grade T1 Urothelial Carcinoma. Curr Urol Rep 2018;19:103. CR - 3. Müller-Hermelink HK, Engel P, Kuo T, et al. Pathology & genetics, tumours of the lung, pleura, thymus and heart. World Health Organization Classification of Tumors Travis WD, Brambilla E, Müller-Hermelink HK, Harris CC, Eds IARC Press, Lyon. 2004:146-47. CR - 4. 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