Thulium laser vapor resection in giant bladder leiomyoma: case report and literature review

Abstract

Introduction: Giant bladder leiomyomas are rare benign tumors that may clinically and radiologically mimic malignant neoplasms. When large or located near the bladder neck, they are traditionally managed through open or laparoscopic approaches due to concerns regarding incomplete resection and significant bleeding.

Case presentation: A 41-year-old man presented with a three-year history of intermittent hematuria. Imaging revealed a 61.6 × 54.9 × 43 mm intravesical mass. Endoscopic thulium laser vaporresection was performed, revealing an approximately 8 × 7 × 7 cm pedunculated tumor occupying 90 % of the bladder lumen and attached to the bladder neck by a broad pedicle. Complete resection was achieved without intraoperative or postoperative complications. Histopathological analysis confirmed bladder leiomyoma (actin and desmin positive; CD117 and S100 negative). No recurrence was observed at six-month follow-up.

Conclusion: To our knowledge, reports of giant bladder leiomyomas successfully treated endoscopically with thulium laser are scarce. This case suggests that, in carefully selected patients, endoscopic management may expand traditional treatment boundaries and potentially avoid more invasive surgical approaches.