膀胱平滑筋腫の2例

Abstract

症例1は41歳女, 主訴は頻尿.超音波検査, 点滴注入腎盂造影, CTなどで膀胱左前壁に大きな充実性腫瘍を認め, MRIのT1強調像では内部均一な低信号, T2強調像では内部不均一な低信号の腫瘍であった.膀胱鏡では大きな粘膜下腫瘍を認めた.膀胱部分切除を行い, 以後36ヵ月間, 再発, 転移をみない.症例2は32歳男, 主訴は肉眼的血尿.膀胱の超音波検査とMRIで前壁に大きな腫瘍が見られた.膀胱鏡では前壁に粘膜下腫瘍を認めたが, 尿細胞診では悪性所見は無かった.生検試料では粘膜に炎症反応を見るに止まった.膀胱部分切除を行い, 29ヵ月間再発, 転移を見ない.両腫瘍の組織診断は膀胱の平滑筋腫であった

We report 2 cases of leiomyoma of the urinary bladder. A 41-year-old female visited our hospital with the complaint of pollakisuria. A solid tumor of the urinary bladder was found by ultrasonography. A large shadow defect at the left-anterior wall was shown by drip infusion pyelography (DIP). Computed tomographic scan (CT) and magnetic resonance imaging (MRI) also revealed a large tumor. T1-weighted image revealed a homogeneous low intensity tumor and T2-weighted image disclosed heterogeneous low intensity tumor. Cystoscopy revealed a large submucosal tumor. Partial cystectomy was performed, and she has had neither recurrence nor metastasis for 36 months. A 32-year-old male was referred to our hospital with the complaint of macrohematuria. A solid tumor of the urinary bladder was found by ultrasonography. A shadow defect was not clearly detected by DIP. A large tumor was detected on the anterior wall by MRI. T1-weighted image showed a homogeneous low intensity tumor and T2-weighted image disclosed a high intensity tumor. Cystoscopy revealed a submucosal tumor on the anterior wall. Urine cytology did not suggest a malignancy. The biopsied specimens revealed only an inflammatory change in the mucosa. Partial cystectomy was carried out. He has had neither recurrence nor metastasis for 29 months. Histological diagnosis in both cases was leiomyoma of the urinary bladder.