膀胱近傍の腫瘤性病変に対する膀胱全層生検法の応用

Abstract

経尿道的あるいは経皮的膀胱全層生検法は非侵襲的で簡単に施行でき安全性も高く, 膀胱癌の深達度診断, neoadjuvant療法の評価に加えて, 膀胱近傍の腫瘤性病変の質的診断にも応用でき, 今後一般的な検査法となることが十分期待される

We have reported the usefulness of percutaneous or transurethral whole layer core biopsy (WLCB) of bladder wall for staging of invasive bladder cancer. We have applied WLCB to 3 cases of paravesical tumor with good results. The first case was in a 3-year-old boy suspected of retrovesical sarcoma. Percutaneous WLCB revealed an inflammatory tumor of the Douglas cavity which was probably caused by perforation of appendix. The tumor disappeared by antibiotics alone. The second case was in a 37-year-old female with retrovesical tumor suspected to be ovarial cancer because of the high value of CA19-9 and CA125. Transurethral WLCB showed invasion of endometriosis to bladder muscle layer. The third case was in a 75-year-old female diagnosed by transurethral WLCB as sigmoid colon cancer invading until the deep bladder muscle layer. Cold cup punch biopsy was not informative in these 3 cases. Percutaneous or transurethral WLCB is safe and easy to perform, and is a technique recommended for diagnosis of pathology and bladder invasion of paravesical tumor.