Bladder venous malformation
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UROLOGY - LETTER TO THE EDITOR
Bladder venous malformation Ricardo Menezes Azevedo1 · Joabe de Oliveira Carneiro1 · Nataly Dantas Fortes da Silva2 · Daniel Abensur Athanazio2,3 Received: 31 August 2020 / Accepted: 10 September 2020 © Springer Nature B.V. 2020
Keywords Haemangioma · Urinary bladder · Vascular neoplasms Editor, Although considered congenital lesions, hemangiomas are usually diagnosed in adults [1, 2]. The revised classification of vascular anomalies by International Society for the Study of Vascular Anomalies (ISSVA) renamed lesions formerly known as cavernous hemangiomas to common venous malformation [3]. It is a rare lesion in the urinary bladder, and we illustrate here in the imaging, cystoscopy, and histologic findings of this peculiar lesion (see Fig. 1). We describe the case of a 51-year-old male patient in clinical follow-up for renal clear cell carcinoma treated with partial nephrectomy. The patient was asymptomatic. Routine follow-up ultrasound showed a 1.0-cm protruded nodule in bladder mucosa of the posterior wall. In cystoscopy, a violaceous nodule of swollen appearance was observed and surgically removed by local excision. In microscopy,
the lamina propria showed an ill-defined lesion composed by large venous spaces lined by typical endothelial cells. At higher magnification, occasional foamy and hemosiderinladen macrophages were noted within the lesion. True neoplastic hemangiomas and vascular malformations are rare in the urinary bladder. They predominate in males (3–4:1) with a mean age of 58 years. The most common location is the posterolateral wall. In cystoscopy or gross examination, a blue multiloculated mass is highly suggestive. The most relevant differential diagnoses are granulation tissue (with possible association with polypoid cystitis), angiosarcoma and Kaposi sarcoma. Usually, no ancillary studies are required for this distinction. Treatment usually depends on size and location and options include partial cystectomy, local excision or obliteration with neodymium:yttrium–aluminum-garnet (Nd:YAG) laser [4].
* Daniel Abensur Athanazio [email protected] 1
Centro Médico Do Hospital da Bahia, Av. Prof. Magalhães Neto, 1541 ‑ Pituba, Salvador, BA 40243‑380, Brazil
2
Laboratory of Pathology, Imagepat, Rua Lucaia 209, Salvador, BA 41940‑660, Brazil
3
Hospital Universitário Professor Edgard Santos/Federal University of Bahia, Rua Dr. Augusto Viana, S/n ‑ Canela, Salvador, BA 40110‑060, Brazil
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International Urology and Nephrology
Fig. 1 Bladder haemangioma. Protruded tumor at bladder ultrasound image (a) and cystoscopic appearance of a violet protruded mucosal nodule (b). HE stain show large vascular spaces in lamina propria
(c, 40 × ; d, 100 × and e, 400 ×). At higher magnification, occasional foamy and hemosiderin- laden macrophages are seen (f, 400 ×)
References
4. Zhou M, Magi-Galluzzi C (2015) Genitourinary pathology: a volume in foundations in diagnostic pathology series. Elsevier, Philadelphia
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