De novo angiosarcoma of the bladder: A case report

De novo primary angiosarcoma of the bladder in the absence of radiation has only been reported in 20 cases worldwide. If patients with prior a history of radiation or cancer are included this number climbs to nearly 50 reported cases. Here, we report the 21st case of bladder angiosarcoma with primary origin in the absence of any known carcinogenic exposures. We describe a 62-year-old male with intermittent hematuria who had a 2.5 cm bladder mass on a CT scan. He was initially treated with a TURBT down to the muscularis layer without evidence of invasion, followed by discharge from the hospital. Ultimately, the patient underwent definitive management with a radical cystoprostatectomy and bilateral pelvic lymph node dissection. A comprehensive review of the literature was also conducted. Given the nature of these aggressive tumors, most patients expired within one year of diagnosis, but a multimodal approach suggested a survival benefit in four of seven patients. Overall, this is an aggressive tumor with a benign presentation and should be included in the differential as the number of cases reported have increased over the past 50 years.