膀胱平滑筋腫に移行上皮癌を合併した1例

Abstract

60歳男.原発性膀胱腫瘍において, 上皮性腫瘍である移行上皮癌と, 非上皮性腫瘍である平滑筋腫が合併症例を報告した.本症例では膀胱内に突出した前立腺組織の為, 通常の硬性内視鏡検査が十分に施行できず, 軟性鏡を使って近接した2ヶ所に腫瘍片の指摘ができた

We report a case of leiomyoma of the urinary bladder associated with transitional cell carcinoma. A 60-year-old-male was referred to our hospital because of the complaint of dysuria and for detailed examination of left hydronephrosis. Drip infusion pyelography revealed left uretero-vesico junction stenosis. Flexible cystoscopy revealed benign prostatic hypertrophy and epithelial bladder tumor at the bladder neck and left ureteral orifice. The tumor was histologically diagnosed as TCC (transitional cell carcinoma). M-VAC chemotherapy (methotrexate 30 mg/m2, day 1, 15, 22, vinblastine 3 mg/m2, day 1, 15, 22, adriamycin 30 mg/m2, day 2, cisplatin 70 mg/m2, day 2) was performed as a neoadjuvant chemotherapy. However, since pelvic MRI revealed tumor invasion in to the muscle area, total cystoprostatourethrectomy and ileal conduit were done. Pathological examination of the tumor of left ureteral orifice revealed TCC, G2, INF beta, pT1, ly0, v(-), pN0, PM0. The tumor in the bladder neck was histologically diagnosed as submuscosal type leiomyoma. No cases of leiomyoma of the urinary bladder associated with transitional cell carcinoma have been reported in Japan.