ABSTRACT
We describe five patients who recently presented with gross hematuria secondary to inflammatory pseudotumors of the bladder along with a review of the literature. At presentation, four of the five patients were clinically misdiagnosed as malignancies of which two were further believed to be leiomyosarcomas on initial histological examination because of their spindle-cell appearance. Conservative excision either by transurethral resection or partial cystectomy was curative in all cases. The main importance of these rare, benign lesions is to differentiate them from malignant tumors for which they may be mistaken, thus avoiding radical surgery and its attendant complications.
Subject(s)
Diagnostic Errors , Granuloma, Plasma Cell/diagnosis , Urinary Bladder Diseases/diagnosis , Adolescent , Adult , Cystectomy , Desmin/analysis , Diagnosis, Differential , Female , Granuloma, Plasma Cell/surgery , Hematuria/etiology , Humans , Keratins/analysis , Leiomyosarcoma/diagnosis , Male , Middle Aged , Urinary Bladder Diseases/surgery , Urinary Bladder Neoplasms/diagnosis , Vimentin/analysisABSTRACT
BACKGROUND: Extrapulmonary inflammatory pseudotumor (plasma cell granuloma) is an uncommon lesion in adults and children, and little is known either of its etiology or clinical characteristics. However, it remains a significant source of morbidity to patients and confusion to clinicians. METHODS: Case reports are presented of three patients with intraabdominal inflammatory pseudotumor who recently underwent surgery. A review of the recent world literature is also presented. Clinical and laboratory characteristics of omental-mesenteric inflammatory pseudotumor are reviewed along with a discussion of its etiology. RESULTS: Cytogenetic data from cells of one patient show a derivative chromosome evolved from a translocation between the long arm of chromosome 2 and the short arm of chromosome 9 [(2;9)(q1,3;p2,2)]. CONCLUSIONS: The lesion is monoclonal, and genetic changes may play a crucial role in the development of this neoplasm. Omental-mesenteric inflammatory pseudotumor appears to represent a distinct clinicopathologic entity as a benign neoplasm in children.
