胃癌からリンパ行性に転移したと考えられる転移性膀胱腫瘍の1例

Abstract

症例は59歳の男性で, 頻尿, 排尿時痛, 肉眼的血尿を主訴とし受診した.膀胱内視鏡にて全周性の腫瘍性病変を認め, 腹部超音波で両側性水腎症が存在し, 血清クレアチニン値の上昇を認めたため入院した.1996年10月頃に胃部不快感, 食欲低下から胃内視鏡検査を行い腺癌の診断で胃全摘を行い, 病理組織学的診断はmucinous adenocarcinomaであった.膀胱腫瘍の病理診断を得るためにTUR-BTを施行し, 膀胱の腫瘍は粘液の産生を示すsignet ringcell carcinomaであり, リンパ管侵襲が著明に認められ, 胃の病理組織像と比較して, 胃癌からのリンパ行性転移と診断した

A 59-year-old man was referred to our clinic with a complaint of frequent urination, voiding pain, and macroscopic hematuria. He had undergone total gastrectomy for mucinous adenocarcinoma, 21 months earlier. Pelvic computed tomography revealed a thick bladder wall all around. There were no other metastatic sites except for paraaortic lymph nodes. Transurethral resection of the bladder tumor was performed. The specimen showed signet ring cell carcinoma and revealed the same pathological findings as the primary gastric cancer. We diagnosed him with metastastic bladder tumor lymphogenously disseminated from gastric cancer. Such lymphogenous metastases from gastric cancer at the entire bladder wall without other apparent lesions have rarely been reported in the Japanese literature.