Skip to main content
Top
Published in: BMC Urology 1/2006

Open Access 01-12-2006 | Case report

Primary PEComa of the bladder treated with primary excision and adjuvant interferon-alpha immunotherapy: a case report

Authors: Jeremy R Parfitt, Anthony J Bella, Bret M Wehrli, Jonathan I Izawa

Published in: BMC Urology | Issue 1/2006

Login to get access

Abstract

Background

Perivascular epithelioid cell tumors (PEComas) are rare mesenchymal neoplasms of uncertain malignant potential, which have in common the co-expression of muscle and melanocytic immunohistochemical markers.

Case presentation

A 48-year-old man presented with dysuria, passage of urinary sediment and lower abdominal discomfort. A three centimeter mass was identified by cystoscopy in the posterior midline of the bladder. Computerized tomography suggested an enterovesical fistula. The patient underwent laparotomy, partial cystectomy and partial small bowel resection. Pathological examination revealed PEComa of the bladder. The patient underwent adjuvant interferon-α immunotherapy. Subsequent follow-up procedures, including cystoscopy and imaging, have not revealed evidence of recurrence. The patient is clinically free of disease 48 months after surgery.

Conclusion

This case represents the second documented PEComa of bladder and demonstrates that adjuvant therapies, including anti-angiogenic and immunotherapy, may be considered for patients with locally advanced or metastatic genitourinary PEComa.
Appendix
Available only for authorised users
Literature
1.
go back to reference Zamboni G, Pea M, Martignoni G, Zancanaro C, Faccioli G, Gilioli E, Pederzoli P, Bonetti F: Clear cell "sugar" tumor of the pancreas. A novel member of the family of lesions characterized by the presence of perivascular epithelioid cells. Am J Surg Pathol. 1996, 20: 722-730. 10.1097/00000478-199606000-00010.CrossRefPubMed Zamboni G, Pea M, Martignoni G, Zancanaro C, Faccioli G, Gilioli E, Pederzoli P, Bonetti F: Clear cell "sugar" tumor of the pancreas. A novel member of the family of lesions characterized by the presence of perivascular epithelioid cells. Am J Surg Pathol. 1996, 20: 722-730. 10.1097/00000478-199606000-00010.CrossRefPubMed
2.
go back to reference Folpe AL: Neoplasms with perivascular epithelioid cell differentiation (PEComas). World Health Organization Classification of Tumors: Pathology and Genetics of Tumors of Soft Tissue and Bone. Edited by: Fletcher CDM, Unni KK, Mertens F. 2002, Lyon: IARC Press, 221-222. Folpe AL: Neoplasms with perivascular epithelioid cell differentiation (PEComas). World Health Organization Classification of Tumors: Pathology and Genetics of Tumors of Soft Tissue and Bone. Edited by: Fletcher CDM, Unni KK, Mertens F. 2002, Lyon: IARC Press, 221-222.
3.
go back to reference Evert M, Wardelmann E, Nestler G, Schulz HU, Roessner A, Rocken C: Abdominopelvic perivascular epithelioid cell sarcoma (malignant PEComa) mimicking gastrointestinal stromal tumor of the rectum. Histopathology. 2005, 46: 115-117. 10.1111/j.1365-2559.2005.01991.x.CrossRefPubMed Evert M, Wardelmann E, Nestler G, Schulz HU, Roessner A, Rocken C: Abdominopelvic perivascular epithelioid cell sarcoma (malignant PEComa) mimicking gastrointestinal stromal tumor of the rectum. Histopathology. 2005, 46: 115-117. 10.1111/j.1365-2559.2005.01991.x.CrossRefPubMed
4.
go back to reference Harris GC, McCulloch TA, Perks G, Fisher C: Malignant perivascular epithelioid cell tumor ("PEComa") of soft tissue: a unique case. Am J Surg Pathol. 2004, 28: 1655-1658.CrossRefPubMed Harris GC, McCulloch TA, Perks G, Fisher C: Malignant perivascular epithelioid cell tumor ("PEComa") of soft tissue: a unique case. Am J Surg Pathol. 2004, 28: 1655-1658.CrossRefPubMed
6.
go back to reference Sadeghi S, Krigman H, Maluf H: Perivascular epithelioid clear cell tumor of the common bile duct. Am J Surg Pathol. 2004, 28: 1107-1110.CrossRefPubMed Sadeghi S, Krigman H, Maluf H: Perivascular epithelioid clear cell tumor of the common bile duct. Am J Surg Pathol. 2004, 28: 1107-1110.CrossRefPubMed
7.
go back to reference Pan CC, Yang AH, Chiang H: Malignant perivascular epithelioid cell tumor involving the prostate. Arch Pathol Lab Med. 2003, 127: E96-98.PubMed Pan CC, Yang AH, Chiang H: Malignant perivascular epithelioid cell tumor involving the prostate. Arch Pathol Lab Med. 2003, 127: E96-98.PubMed
8.
go back to reference Pan CC, Yu IT, Yang AH, Chiang H: Clear cell myomelanocytic tumor of the urinary bladder. Am J Surg Pathol. 2003, 27: 689-692. 10.1097/00000478-200305000-00013.CrossRefPubMed Pan CC, Yu IT, Yang AH, Chiang H: Clear cell myomelanocytic tumor of the urinary bladder. Am J Surg Pathol. 2003, 27: 689-692. 10.1097/00000478-200305000-00013.CrossRefPubMed
9.
go back to reference Folpe AL, Mentzel T, Lehr HA, Fisher C, Balzer BL, Weiss SW: Perivascular epithelioid cell neoplasms of soft tissue and gynecologic origin: a clinicopathologic study of 26 cases and review of the literature. Am J Surg Pathol. 2005, 29: 1558-1575. 10.1097/01.pas.0000173232.22117.37.CrossRefPubMed Folpe AL, Mentzel T, Lehr HA, Fisher C, Balzer BL, Weiss SW: Perivascular epithelioid cell neoplasms of soft tissue and gynecologic origin: a clinicopathologic study of 26 cases and review of the literature. Am J Surg Pathol. 2005, 29: 1558-1575. 10.1097/01.pas.0000173232.22117.37.CrossRefPubMed
10.
go back to reference Hornick JL, Fletcher CDM: PEComa: what do we know so far?. Histopathology. 2006, 48: 75-82. 10.1111/j.1365-2559.2005.02316.x.CrossRefPubMed Hornick JL, Fletcher CDM: PEComa: what do we know so far?. Histopathology. 2006, 48: 75-82. 10.1111/j.1365-2559.2005.02316.x.CrossRefPubMed
11.
go back to reference Dreau D, Foster M, Hogg M, Swiggett J, Holder WD, White RL: Angiogenic and immune parameters during recombinant interferon-alpha2b adjuvant treatment in patients with melanoma. Oncol Res. 2000, 12: 241-51.PubMed Dreau D, Foster M, Hogg M, Swiggett J, Holder WD, White RL: Angiogenic and immune parameters during recombinant interferon-alpha2b adjuvant treatment in patients with melanoma. Oncol Res. 2000, 12: 241-51.PubMed
12.
go back to reference Ezekowitz RA, Mulliken JB, Folkman J: Interferon alfa-2a therapy for life-threatening hemangiomas of infancy. N Engl J Med. 1992, 326: 1456-1463.CrossRefPubMed Ezekowitz RA, Mulliken JB, Folkman J: Interferon alfa-2a therapy for life-threatening hemangiomas of infancy. N Engl J Med. 1992, 326: 1456-1463.CrossRefPubMed
13.
go back to reference Ezekowitz RA, Mulliken JB, Folkman J: Additional corrections: interferon alfa-2a for hemangiomas of infancy. N Engl J Med. 1995, 333: 595-596. 10.1056/NEJM199508313330913.CrossRefPubMed Ezekowitz RA, Mulliken JB, Folkman J: Additional corrections: interferon alfa-2a for hemangiomas of infancy. N Engl J Med. 1995, 333: 595-596. 10.1056/NEJM199508313330913.CrossRefPubMed
14.
go back to reference Rigby H, Yu W, Schmidt MH, Fernandez CV: Lack of response of a metastatic renal perivascular epithelial cell tumor (PEComa) to successive courses of DTIC based-therapy and imatinib mesylate. Pediatr Blood Cancer. 2005, 45: 202-6. 10.1002/pbc.20305.CrossRefPubMed Rigby H, Yu W, Schmidt MH, Fernandez CV: Lack of response of a metastatic renal perivascular epithelial cell tumor (PEComa) to successive courses of DTIC based-therapy and imatinib mesylate. Pediatr Blood Cancer. 2005, 45: 202-6. 10.1002/pbc.20305.CrossRefPubMed
15.
go back to reference Deenik W, Mooi WJ, Rutgers EJ, Peterse JL, Hart AA, Kroon BB: Clear cell sarcoma (malignant melanoma) of soft parts: a clinicopathologic study of 30 cases. Cancer. 1999, 86: 969-75. 10.1002/(SICI)1097-0142(19990915)86:6<969::AID-CNCR11>3.0.CO;2-Z.CrossRefPubMed Deenik W, Mooi WJ, Rutgers EJ, Peterse JL, Hart AA, Kroon BB: Clear cell sarcoma (malignant melanoma) of soft parts: a clinicopathologic study of 30 cases. Cancer. 1999, 86: 969-75. 10.1002/(SICI)1097-0142(19990915)86:6<969::AID-CNCR11>3.0.CO;2-Z.CrossRefPubMed
Metadata
Title
Primary PEComa of the bladder treated with primary excision and adjuvant interferon-alpha immunotherapy: a case report
Authors
Jeremy R Parfitt
Anthony J Bella
Bret M Wehrli
Jonathan I Izawa
Publication date
01-12-2006
Publisher
BioMed Central
Published in
BMC Urology / Issue 1/2006
Electronic ISSN: 1471-2490
DOI
https://doi.org/10.1186/1471-2490-6-20

Other articles of this Issue 1/2006

BMC Urology 1/2006 Go to the issue