MRIが診断に有用であった早期尿膜管癌の1例

Abstract

2ヵ月前に検診で顕微鏡的血尿が認められ, 膀胱鏡下コールド・パンチ生検で腺癌と診断され, 当科に紹介された46歳男.MRIでは膀胱頂部に小さい腫瘤が認められた.早期尿膜管癌の診断で膀胱部分切除を行い, 尿膜管と一塊にして切除し, 骨盤リンパ節郭清を行った.組織学的に結腸癌の様な乳頭状腺癌が認められたが, 膀胱壁及び尿膜管には癌細胞浸潤はなく, 骨盤リンパ節転移もなかった.術後5ヵ月の現在, 再発や転移の証拠はない

A case of an early urachal carcinoma is reported. A 46-year-old man was referred to our hospital because of urinary bladder tumor. Microhematuria had been detected by a medical health examination two months earlier. Gold punch biopsy under cystoscopy proved adenocarcinoma. Sagittal view in magnetic resonance imaging (MRI) clearly demonstrated a small tumor at the bladder dome. En bloc partial cystectomy and pelvic lymphadenectomy was performed under diagnosis of early urachal carcinoma. Microscopically, papillary adenocarcinoma like colon carcinoma was revealed, but the bladder wall and urachus were free from the infiltration of carcinoma cells and no pelvic lymph node metastasis was found. There has been no evidence of recurrence or metastasis 5 months after the operation.