膀胱尿道摘除8年後,残存尿道及び鼠径部リンパ節へ再発をきたした膀胱癌の1例

Abstract

59歳男.51歳時に前立腺部尿道を含めた膀胱内の多発性腫瘍に対し, 膀胱尿道摘除術を受けたが, その8年後, 尿道口よりの排膿を主訴に来院した.陰茎部MRI, 胸腹部CTにより, 残存尿道腫瘍及び左鼠茎部リンパ節転移と診断し, 陰茎部分切除術, 左鼠径部リンパ節切除術を施行した.切除標本の病理組織学的所見は, 8年前と同様の移行上皮癌で, 膀胱癌の転移と考えられた.術後, 補助療法としてM-VAC療法を2コース行った.術後3年2ヵ月の現在, 再発を認めていない

A 59-year-old man had undergone total cystourethrectomy for bladder cancer (TCC G2 > G3 pT1) in July, 1991. Eight years later, he visited our department complaining of bleeding from external urethral meatus. Imaging study including computed tomographic (CT) scan and magnetic resonance imaging (MRI) showed a tumor arising from the urethral remnant and left inguinal lymph node involvement. Partial penectomy and left inguinal lymphadenectomy were performed. Histopathological examination revealed that both tumors were transitional cell carcinomas suggesting recurrence of bladder cancer. Two courses of M-VAC chemotherapy were given as adjuvant therapy.