膀胱腫瘍の膀胱全摘後尿道再発

Abstract

Two cases of urethral recurrence following total cystectomy for carcinoma of the urinary bladder are presented. Case 1: A 44-year-old man was admitted on June 22, 1970 with a chief complaint of asymptomatic hematuria. Multiple papillary tumors were found around the left ureteral orifice and near the bladder neck, and total cystectomy including prostatovesiculectomy and ileal loop diversion was performed on July 8, 1970. Removed tissue showed multiple transitional cell papillary carcinoma grade 2, Jewett B2 • In October, 1970, 3 months after cystectomy, he noticed a small papillary tumor at meatus and a bloody urethral discharge. The tumor was resected and the tissue showed transitional cell carcinoma grade 2, which was considered as recurrence of bladder carcinoma. In April, 1971 he noticed a blood urethral discharge again, and urethrectomy was performed. Metastatic changes were foundy at the scrotal skin and the right inguinal lymphnodes, 1 year after urethrectomy. The outcome was fatal Case 2: A 56-year-old man underwent total cystectomy including prostatovesiculectomy with ileal loop diversion on May 15, 1972, for multiple papillary grade 2 transitional cell carcinoma of the bladder without muscle invasion. On December 23, 1973, 19 months after the operation, urethral bleeding occmed, and then urethrectomy was performed. Resected urethra showed multiple papillary transitional cell carcinoma grade 2 at whole area. Metastatic sign was found on the pubis, 8 months after urethrectomy. This represents a 4.00% recurrence rate, and is considered to be of sufficient importance to warrant inclusion of urethrectomy at the time of cystectomy. Review of literatures and some discussion on urethral recurrence of bladder tumor were done.