膀胱憩室腫瘍の1例

Abstract

Carcinoma of the bladder diverticulum is a relatively rare disease. However, its preoperative diagnosis is often difficult. Also, infiltration occurs easily because the diverticulum wall is thin, and prognosis is said to be relatively poor. Histologically, the occurrence rate of squamous cell carcinoma is markedly high. We have experienced a case of squamous cell carcinoma in the bladder diverticulum occurring simultaneously with transitional cell carcinoma of the bladder; and, report this case along with a review of the literature. The patient, a 79-year-old male, had sudden macroscopic hematuria on December 15, 1980, and went to the urology department of a separate hospital. IVU showed distortion of the right ureter, and the patient was referred to our hospital. Cystoscopy revealed a diverticulum in the right wall of the bladder. In the posterior wall of the bladder 2 papillary sessile tumors were also detected. Pathological diagnosis by cold punch biopsy done after the patient was admitted to hospital revealed a grade III transitional cell carcinoma. Total cystectomy + bilateral cutaneous ureterostomy was performed. The diverticulum was in the right wall of the bladder and a papillary sessile tumor with a diameter of 4 cm was found in the diverticulum. A papillary sessile tumor 2 cm in diameter was found in the left bladder wall. Histopathological diagnosis of the tumor in the diverticulum was squamous cell carcinoma ( pG2 , pT3b , ly1, v(-) INF beta) and that of the tumor in the bladder was transitional cell carcinoma ( ( pG3 , pT2 , ly1, v(-), INF gamma).(ABSTRACT TRUNCATED AT 250 WORDS)