S状結腸に浸潤した尿膜管移行上皮癌の1例

Abstract

We report a patient with urachal transitional cell carcinoma invading the sigmoid colon. The diagnostic and therapeutic aspects of this disease are discussed. The literature is also reviewed. This 42-year-old man was admitted with the chief complaint of micturition pain. Operation consisting of total cystourethrectomy, excision of the urachus together with the umbilicus, pelvic lymphadenectomy, ilial conduit plasty, sigmoidectomy, and colorectostomy was performed on June 3, 1986, after the diagnosis of urachal carcinoma invading the sigmoid colon. A tumor the size of a hen's egg was found at the dome of the bladder extending to the sigmoid colon. The urachus 8 cm in length and 2 cm in diameter extended from the site of the tumor to the umbilicus. Histologically the tumor was a transitional cell carcinoma Grade III. The urachus was composed of epithelioid and muscle layers, and its lower end was filled with necrotic inflammatory debris so that the canal was obliterated; tumor cells infiltrated the muscle layer. No metastasis was found in lymphnodes. Combination therapy of 5 fluorouracil, adriamycin and cis-platinum was given after operation. He has returned to work and is doing well without evidence of metastasis or recurrence now at 1 year after the operation.