膀胱類皮嚢胞についてその症例及び本邦丈献のまとめ

Abstract

Dermoid cysts of urinary bladder are a relatively rare occurrence, judging from the small number of cases reported in the urological publications. Primary dermoids of the urinary bladder extremely rare and secondary dermoid cysts of the bladder—perforation of the bladder arising from an ovarian of paravesical dermoid tumors are un-common. This disease was first reported by Wallace in 1700.W allace first drew attention to the phenomenon of the passage of hairs during micturition. In 1895 Clado collected 32 cases of paravesical dermoid cysts from the literature. In 1913 Heller collected 59 cases of dermoid cysts of bladder, in 16 of which the patients was male. Recently in 1939, Litski r eported a case and stated the tota l number of 15 cases in the literature. Since then there is no articlet except of one case report. In Japan, Matubara and Amano first reported a case of se c o ndary dermoid cyst of the bladder of a 14-year-old girl in 1899. Since then, isolated single cases have been reported. In the present paper our tow cases of secondary dermoid cysts of bladder are described and 56 cases that the authors cellected from the Japanese urological literature, in only one case of which the patient was a 13-year-old boy of primary dermoid of urinary bladder, are reviewed in detail. (See each table.) Case report. 1) R.M., a 45-year-oldJ apa n ese woman, was first seen by our clinic on July 1947, for miction pain, pollakiuria and spontaneous discharge of small calculi, At this time a diagnosis of dedmoid cyst of the urinary bladder was made by a cystoscopic examination. A patient disliked for removal of the dermoid tumor of bladder, therefore transurethral lithotripsy was made by Young 's rongeur now and then. Five years later she passed a faeces per urethra with urine. After a while she died on March 1954. 2) K. M., a Japanese housewife aged 56 years, began to notice frequency on urination, pain at the end of urination, hematuria and pain in the lower abdomen. On July 1955 she was first seen by our clinic, At this time a cystoscopic examination was performed, Our first diagnosis was a urachal calculus. Suprapubic cystotomy was made and the tumor, that is 4.0 by 3.2 by 2.0 cm with hair, teeth and deposited calicium was found to be extending through the bladder. There was certainly dermoid cyst of bladder. When the peritoneum was opened the tumor was found to arise from the right ovary. The tumor mass was removed and than the bladder was closed with catgut and the peritoneum was closed with a continuous sutur of silk. A Nelaton's catheter was inserted into the bladder through the urethra for drainage. The patient made smooth recovery. Read at 186th Meeting in Kyoto Section of Japan Urological Association, December 15, 1956.