膀胱原発の印環細胞癌の1例

Abstract

71歳男.肉眼的血尿を主訴とした.腹部超音波検査により膀胱腫瘍を指摘され, 精査目的で入院となる.尿細胞診は陰性で, PSAも正常値であった.骨盤部CT検査でも均一な膀胱後壁から左側壁にかけての腫瘍が認められた.経尿道的生検術を施行し, 病理組織学的に印環細胞癌であった.膀胱全摘術を行い, 外来にて化学療法を施行中である.一般的に印環細胞癌は予後不良であり, 自験例でも腫瘍は膀胱漿膜を超え周囲脂肪組織や前立腺に浸潤し, リンパ節への転移もみられ予後不良と考えられた

Gross hematuria and urinary frequency caused a 71-year-old man to visit our hospital. A non-papillary tumor was identified on the posterior wall of the urinary bladder and the pathological diagnosis was signet ring cell carcinoma. Upper gastrointestinal endoscopy, computed tomographic scanning, barium enema revealed no involvement of other organs. Radical cystectomy and creation of an ileal conduit were performed. The histopathological stage was pT4N1M0. Apart from subacute ileus, the postoperative course was uneventful. Signet ring cell carcinoma of the bladder is a rare entity and we have identified 41 cases in the Japanese literature. This tumor usually has a poor prognosis. Our patient is currently free from disease at 5 months after the surgery.