膀胱浸潤をきたした虫垂粘液嚢胞腺癌の1例

Abstract

81歳女.肉眼的血尿を主訴とし, 膀胱鏡, 静脈性腎盂造影検査で膀胱腫瘍が認められた.経尿道的生検術の病理組織学的診断はムチン産生腺癌であった.注腸造影検査では虫垂が全く造影されず, 骨盤部MRI T2強調像では, 膀胱腫瘍は膀胱壁外で管状の構造に移行し盲腸に連続する像が認められた.原発性虫垂癌の膀胱浸潤の可能性を強く疑い手術を施行し, 病理組織学的診断は虫垂原発粘液嚢胞腺癌であった.右側後壁にムチン産生腺癌を認めた場合, 原発性膀胱腺癌に加え虫垂, 卵巣を含めた浸潤, 転移性腫瘍の可能性を考慮し, 精査加療が必要と考えられた.膀胱浸潤をきたした虫垂癌の報告は16例あった

The patient, an 81-year-old woman, had the chief complaint of macroscopic hematuria. Cystoscopy revealed a bladder tumor, which was determined by biopsy to be mucin-producing adenocarcinoma. Appendiceal carcinoma that invaded the bladder were diagnosed preoperatively by air-contract barium enema and magnetic resonance. She was treated with partial cystectomy and resection of the cecum. Sixteen cases of appendiceal carcinoma with invasion into the bladder have been reported in Japan.