A rare case report of bladder extragastrointestinal stromal tumor is being reported, which presented as a leiomyoma on imaging studies in a patient with recurrent postmenopausal bleeding. This is the fifth case being reported in the literature.
A 54-year-old woman reported to outpatient department (OPD) of a tertiary level government hospital with recurrent postmenopausal bleeding. The general physical examination of the patient was normal and vital signs were stable. On abdominal examination, a firm mass was felt arising from the pelvis corresponding to a 16-week size uterus. The ultrasound (USG) report mentioned a 12 × 12.7 × 10.8 cm well-defined heterogeneously hypoechoic lesion with areas of central necrosis arising from the anterior wall of the uterus. Contrast-enhanced computerized tomography (CECT) was reported as a subserosal degenerative fibroid with bilateral normal ovaries. The patient was investigated and planned for hysterectomy in view of recurrent postmenopausal bleeding with a large fibroid. Intraoperatively, the uterus, bilateral tubes, and ovaries were found to be normal. A 16 × 14 cm yellowish-firm mass with multiple areas of cystic degeneration and necrosis was seen on the right side, which appeared to be arising from the bladder. A hysterectomy with bilateral salpingo-oophorectomy was done. A tumor was seen arising from the posterior wall of the supratrigonal region of the bladder. A complete resection of the tumor was done and the bladder was repaired in two layers. Metastasis and any other primary foci were ruled out. On immunohistochemistry (IHC), the tumor was positive for CD117, desmin, and DOG1. The final impression was a gastrointestinal stromal tumor of the urinary bladder.