Bladder sarcomatoid carcinoma is a rare, aggressive tumor with epithelial and mesenchymal features. We report a 69-year-old man with muscle-invasive bladder neck urothelial carcinoma with giant cell subtype. After two cycles of gemcitabine and cisplatin, imaging revealed tumor shrinkage. Robot-assisted radical cystectomy with pelvic lymphadenectomy and intracorporeal ileal conduit was performed. Pathology confirmed sarcomatoid carcinoma with lymphovascular invasion but negative margins. The urothelial component responded to chemotherapy, whereas the sarcomatoid component did not. No recurrence was observed for 18 months follow-up. Prompt chemotherapy and robotic surgery achieved a favorable outcome in this rare bladder cancer.
Taniguchi et al. (Sun,) studied this question.