経尿道的膀胱腫瘍切除術後8年目に尿道舟状窩および亀頭皮膚に上皮内癌の再発をみた1例

Abstract

63歳男性.患者は表在性膀胱癌に対する経尿道的膀胱腫瘍切除術後8年目に外尿道口部発赤が出現し, 精査加療目的に入院となった.入院時, 自然尿細胞診はclass IVで, 画像所見では異常はみられなかった.膀胱および尿道ランダム生検の結果, 膀胱癌の尿道舟状窩および亀頭部皮膚への限局性の再発と診断し, 陰茎部分切除術, 両側浅鼠径リンパ節郭清術を施行した.病理組織学的に転移性尿路上皮癌と診断され, 術後の尿細胞診は陰性化した

A 63-year-old man underwent transurethral resection of a bladder tumor to treat superficial bladder cancer in 1995. Histological examination showed urothelial carcinoma, G2>G3 with carcinoma in situ (CIS) at the bladder neck. He underwent postoperative intravesical bacillus Calmette-Guerin (BCG) therapy. In June, 2003, he complained of rubor of his external urethral meatus and visited our clinic. Biopsies at the external urethral meatus and the fossa navicularis of the urethra showed CIS. Radiological examinations, cystourethroscopy and multiple biopsies from other sites of urothelium, including bladder and urethral mucosa, did not reveal any other malignancies. Thereafter, partial penectomy and bilateral inguinal lymphadenectomy were performed. Histological examinations showed CIS at the urethral mucosa of the fossa navicularis and the skin of the glans penis. Postoperative urine cytologies were negative.