PMC10210528_01
(a) Longitudinal ultrasonograph of the urinary bladder with the large intraluminal
bladder mass filling most of the lumen. (b) Longitudinal view of the bladder mass with
color flow Doppler centered on the apical region. Several vessels extend from the apical
bladder wall in the mass, suggesting that the mass originated from the apex
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The mass was poorly echogenic with faint linear hyperechoic striations extending from the center of the mass to the periphery (Figure 1a,b). On color flow Doppler, vascularization of the mass was noted at the apex of the bladder, and faint vessels were also present centrally along some of the subtle striations (Figure 1b).
(a) Intraoperative image of the bladder. The bladder was firm and filled by a large
intraluminal mass. A large vascular network can be seen on the serosal surface of the
bladder wall. (b) Transverse section of the mass that shows ulceration (arrow) near its
point of attachment to the urinary bladder
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A partial cystectomy was performed the following day and the 4 x 5 cm ovoid urinary bladder mass was fully excised (Figure 2a). The mass had a 1.5 cm attachment to the apex of the bladder (Figure 2b) and occupied most of the bladder lumen.
Gross anatomic section of the mass showing its homogeneous consistency
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The mass did not extend to the cut margin of the resection (Figure 3). After transecting the mass, the internal texture appeared diffusely homogeneous (Figure 3).
Urinary bladder leiomyoma. Magnification (x 5) of the leiomyoma (*) compressing the
adjacent submucosa (white arrows) which contains areas of hemorrhage. Hematoxylin and
eosin. Bar = 200 microm
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The mass originated from the inner muscular portion of the bladder wall, extended into the submucosa and protruded into the lumen (Figure 4). The mass was composed of neoplastic mesenchymal cells arranged in long interlacing bundles (neoplastic smooth muscle cells) with scant collagenous stroma between the cells (Figure 4).