夜間尿失禁を主訴とする膀胱原発印環細胞癌の1例

Abstract

56歳男.夜間尿失禁, 右腰痛を主訴とし, 膀胱腫瘍を疑い粘膜生検を行った結果はchronic cystitisであったため, 抗コリン剤による保存的療法を開始したが, 症状が軽快せず, 尿管ステントを留置した.膀胱全摘除術+両側尿管皮膚瘻造設術を施行し, 病理組織像は粘膜下に広範に広がる印環細胞癌であった.術後, 追加療法は施行せず, 外来で厳重に経過観察することとなり, 術後20ヵ月目現在, 再発兆候は認めていない

This is a report of our experience of a case of primary signet ring cell carcinoma of the urinary bladder. The patient was a 56-year-old man who was referred to our hospital presenting with incontinence and lumbago. A drip infusion pyelography study indicated bilateral hydronephrosis and a contracted bladder. Signet ring cell carcinoma was observed in the bladder submucosa after the second transurethral biopsy set. No other cancer lesions could be identified even after careful examination. Therefore, it was diagnosed as a primary signet ring cell carcinoma of the bladder. Total cystectomy with bilateral uretero-cutaneostomy reconstruction was performed. The pathological stage was T4bN0M0 and the surgical margin was positive at the site of the pubic bone. Adjuvant therapy was not given. There was no evidence of disease 20 months after the operation. In Japan, this is the third case of primary signet ring cell carcinoma of the bladder presenting as incontinence.