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Primary Urinary Bladder Angiosarcoma with Osteoclast-Like Multinucleated Giant Cells: A Case Report and Literature Review

Challenging differential diagnosis, Educational Purpose (only if useful for a systematic review or synthesis), Rare co-existance of disease or pathology

Nariman A. Nawar, Jamie Olsen, Tomislav M. Jelic, Chun He

Department of Pathology, West Virginia University, Morgantown, WV, USA

Am J Case Rep 2016; 17:143-149

DOI: 10.12659/AJCR.896266

Available online:

Published: 2016-03-07

BACKGROUND: Angiosarcoma is a fatal and aggressive mesenchymal tumor. It occurs in skin, breast, and parenchymal organs. It rarely arises primarily in the urinary bladder. Only 13 cases of primary urinary bladder angiosarcoma have been reported in the English literature.
CASE REPORT: The patient was a 68-year-old man who presented to the Emergency Department with inability to void. Computed tomography of the abdomen and pelvis showed a urinary bladder mass. Surgical excision of the mass was performed. Pathological examination results were consistent with angiosarcoma. In addition to the unusual location of this tumor, the pathology was different from the previously reported cases in that this case was rich with osteoclast-like multinucleated giant cells.
CONCLUSIONS: The pathological diagnosis of primary urinary bladder angiosarcoma is challenging. Histological patterns and immunophenotypes are variable. Here, we review all reported cases of primary urinary bladder angiosarcoma, highlight the clinical and morphological features of this malignant neoplasm, and report a unique case of primary urinary bladder angiosarcoma with osteoclast-like multinucleated giant cells.

Keywords: Giant Cells - pathology, Aged, Hemangiosarcoma - pathology, Humans, Male, Urinary Bladder Neoplasms - pathology