Procedure: Trans-urethral resection of bladder tumor (TURBT).

Microscopy: The material is composed almost entirely of smooth muscle with only occasional areas showing lining urothelium which is benign. There is no evidence of necrosis, nuclear pleomorphism or mitotic activity.

Immunohistochemistry: CD34 and Bcl2 are negative, whereas Desmin and smooth muscle actin are strongly positive.

Diagnosis: Leiomyoma.

One month after the initial ultrasound examination, the patient underwent TURBT, which was later followed by the staging CT scan. Finally, after the CT scan, the patient underwent open partial cystectomy.