偶然発見された尿膜管嚢胞に顕微鏡的に尿膜管癌を認めた1例

Abstract

慢性前立腺炎として治療されていた33歳男で腹部超音波検査により尿膜管嚢胞と診断された.膀胱鏡検査で膀胱頂部に隆起性腫瘤を認めた.CT及びMRI上, 腫瘤は大部分が嚢胞性, 一部が充実性であった.尿膜管嚢胞切除及び部分的膀胱切除を行った.組織病理学的に大多数の嚢胞は正常円柱上皮でムチン性物質の貯留を伴っていた.しかし, 数個の小さい嚢胞は管状-絨毛腺腫に似た上皮細胞を含有し, 分裂像を示した.非常に早期に検出された尿膜管癌と結論された

A 33-year-old man who had been treated for chronic prostatitis was diagnosed to have urachal cysts by transabdominal ultrasonography. Cystoscopy revealed protuberance at the dome of the bladder. Computerized tomography scan and magnetic resonance imaging showed the mass to be mostly cystic but partly solid. Resection of the urachal cysts and partial cystectomy were performed. Histopathologically, most cysts had a normal cylindrical epithelium with retention of mucinous substance. However, several small cysts contained epithelial cells resembling tubulo-villous adenoma and showing mitotic figures. This case was concluded as urachal carcinoma detected in its very early stage.