Clinical case

S.A. male 75 years old, came to our observation for macro-haematuria. Abdominal ultrasound showed a huge mass on the posterior wall of the bladder. At ci-stoscopy a vegetant, scissile and nodular neoplasia was observed. Histologic examination classified the tu-mour as “carcinosarcoma “. Abdominal, pelvic and thoracic CT scans excluded extension outside the bladder or nodal disease. Bone scan was negative for skeletal localizations. The patient underwent radical cistoprostatovesciculectomy with ileal conduit. Surgi-cal specimen showed a bulky polipoid cancer of 10 x 5 x 3 cm arising from the posterior and right lateral wal-ls of the bladder, occupying up to 75 % of the visceral lumen (photo 1). On the cutting surface, solid zones alternated to hard-elastic gelatinous greyish lines in a necrotic-haemorragic context. The histological dia-gnosis was “carcinosarcoma extending to submucosal layer with polipoid endoluminal development. No lymph-nodal involvement was observed (pT1 N0 M0)”. No problems occurred up to discharge. After 6 months of close follow-up, the patient is still disease free. Discussion Carcinosarcoma of the bladder is a rare tumour: less than 50 cases are reported (1). The singleness of the cases doesn’t allow an uniformity of therapeutic approach (2). In men it is more frequent than in wo-men with a ratio of 4:1, with greater incidence at the end of the seventh decade fo life. Symptoms at pre-Bladder carcinosarcoma: a case observatio