結核性萎縮膀胱に対する回腸利用膀胱拡大術37年後に発生した腺癌の1例

Abstract

55歳女性の, 尿路結核による萎縮膀胱に対してなされた回腸利用膀胱拡大術の術後37年目に, 回腸膀胱に発生した腺癌例を経験した.腹部正中線切開にて膀胱部分切除術及び上行結腸・回腸利用膀胱拡大術を施行した.術後2年現在, 再発所見はないものの, 排尿困難及び尿路感染症を頻発するため間欠的自己導尿にて経過観察中である

A 55-year-old woman was admitted with urinary frequency. She had undergone augmentation ileocystoplasty due to tuberculous bladder atrophy 37 years previously. Cystoscopy revealed a tumor on the posterior wall which had been augmented with the ileum. Partial cystectomy and bladder reconstruction using a segment of ileum and ascending colon were performed. Gross inspection showed a 15 x 10 mm, papillary tumor on the ileal mucosa near the vesico-ileal anastomosis. Histologically, moderately differentiated adenocarcinoma infiltrating into the muscle layer was surrounded by the normal ileal mucosa. She has been free of recurrence for 2 years postoperatively. This is the 8th case of adenocarcinoma following augmentation ileocystoplasty reported in the Japanese literature.