尿管癌術後経過観察中に発見された前部尿道Fibroepithelial polypの1例

Abstract

52歳男性.尿管癌術後経過観察中に発見された前部尿道Fibroepithelial polypの1例を経験した.前医により左下部尿管腫瘍で左腎尿管全摘術を受け, 経過観察中の尿道膀胱鏡検査で前部尿道腫瘤を認め, 紹介入院した.尿道造影, 尿道エコーで外尿道口より5cmの前部尿道に長径9mm大の細長い有茎腫瘤を認め, 経尿道的切除を行った.病理所見では腫瘤の表面は異型のない移行上皮で覆われ, 粘膜下は浮腫状の線維性組織で占められ, 血管・リンパ管の拡張と軽度炎症細胞浸潤を認め, fibroepithelial polypと診断された

A 52-year-old man underwent nephroureterectomy against left distal ureteral cancer (transitional cell carcinoma, Grade 2, pTa), and was followed up by surveillance alone. Twenty-two months postoperatively, a pedunculated tumor was found in the anterior urethra by cystourethroscopy. Pathological examination of the tumor resected transurethrally revealed a fibroepithelial polyp. There have been only twelve cases of fibroepithelial polyp of the anterior urethra reported in the literature. Since 4 out of 8 adult cases among them were found during the postoperative follow up period of urothelial cancer, mechanical irritation by repeated transurethral procedures might be responsible for the development of fibroepithelial polyp of the anterior urethra in these cases. If anterior urethral tumor is found during follow-up urothelial carcinoma, benign urethral polyp should be considered in the differential diagnosis.