膀胱原発印環細胞癌の1例

Abstract

SY:48歳女.全身倦怠感を主訴とした.頻尿, 残尿感があり, 超音波検査で両側水腎症を認めたため入院した.血液検査で軽度の貧血と腎不全を認め, 尿検査で血尿を認めた.膀胱鏡検査で三角部に腫瘍を認めたため, 腫瘍生検を行った.又, 腹部CT, 胸部CT.骨シンチにより全身への転移を認めた.生検による病理所見より印環細胞癌と診断した.入院当初は膀胱への転移を疑い, 原発巣検索のため他科的検査を行ったが異常は見られず, 膀胱原発と診断した.全身に転移しており, 疼痛コントロールのみで退院した.良好な疼痛コントロールを得たが, 診断の約5ヵ月後死亡した.病理解剖の結果, 膀胱原発で全身に転移した印環細胞癌を確認した

We report a case of signet-ring cell carcinoma of the urinary bladder. A 48-year-old female was hospitalized because of general fatigue, pollakiuria and residual sensation. Renal ultrasonography disclosed bilateral hydronephrosis. The serum level of cretinine was 3.1 mg/dl, and we diagnosed the patient with post-renal failure. Cystoscopic examinations revealed non-papillary sessile tumors in the trigone. Histopathological findings of the biopsy specimen demonstrated signet-ring cell carcinoma. There was no evidence indicating bladder metastasis from the cancer in other organs. The patient died of cachexia 5 months after the diagnosis. She was autopsied, and the diagnosis of signet-ring cell carcinoma of the urinary bladder with metastases in various organs was confirmed. This disease is extremely rare and has a poor prognosis. We review the previous cases reported in the literature.