膀胱後部肉腫(平滑筋肉腫)の1例

Abstract

A 50-year-old man visited our clinic with the chief complaints of dysuria, mass in the lower abdomen with pain and elevated temperature (38.8℃). On physical examination, there was a tumor in the midline suprapubica11y, as far up as the umbilicus, which looked just like a distended bladder with extreme tenderness. Rectal examination revealed a semi-fluctuant, tense mass over the prostate with the resistance similar to that of a distended bladder. Suspicious diagnosis of pyourachus or retrovesical tumor was considered after the examinations of cystoscopy, puncture of the tumor, intravenous pyelography, cystography and rentgenological examination of gastrointestinal tract, etc. Operation was performed on the 5th of March, 1969 under G-O-F general anesthesia. The tumor was located in the space behind the bladder, above the prostate and between the normal seminal vesicles. It was of child's head size, covered with a thin fibrous capsule, and adherent with the ileum and the sigmoid colon. It was removed together with an ileal segment of about 20 cm. Microscopic diagnosis of the tumor was leiomyosarcoma. Thereafter, the patient was given 6000 r of CO60 irradiation. Postoperative course has• been uneventful and there is no sign of recurrence over 7 months follow up. This is the 23 rd case of the retrovesical sarcoma of our country, and a review of these 23 cases was made.