女子尿道憩室に発生した腺癌の1例

Abstract

81歳女.尿道よりの血性分泌物を主訴に受診し, 尿道周囲に腫瘤性病変を認めた.腟前壁に尿道に沿って鶏卵大で弾性軟の腫瘤を触知し, 圧痛はみられなかった.尿細胞診はクラスVで, 移行上皮癌が疑われた.骨盤部CTで尿道周囲に不均一な軟部腫瘤を認めたが, 骨盤部リンパ節に明らかな腫脹はみられなかった.骨盤部MRIで膀胱下面に径4cmの腫瘤を認めた.超音波ガイド下に経腟的針生検を施行し, 腺癌の診断で腫瘍摘出術を施行した

An 81-year-old woman was admitted with a chief complaint of bloody discharge from the urethra. On physical examination an elastic-soft mass was palpable beneath the anterior vaginal wall. Magnetic resonance imaging and computed tomographic scan revealed the mass around the urethra. Transvaginal needle biopsy was performed and the histopathologic finding was adenocarcinoma. The tumor was excised with the uterus, the ovary and the anterior vaginal wall. The macroscopic appearance suggested that the tumor arose in the urethral diverticulum. She had intravesical recurrence at 8 months after the operation, and partial cystectomy was performed. However there was recurrence again, and radical cystectomy was performed finally. We review 81 cases of urethral diverticular carcinoma in the literature.