原発巣再発は認めず子宮転移のみを来たした表在性膀胱癌の1例

Abstract

78歳, 女。肉眼的血尿で受診し, 膀胱後壁に4cm大の有茎性乳頭状腫瘍を認め1ヵ月後TUR-Btを施行し, 病理所見で移行性上皮癌, G3, pT1であった。肉眼的には完全に切除できたと考えたが腫瘍径が大きいことや病理所見を考え再発予防目的でBCG膀胱内注入療法を8回施行した。術後1年10ヵ月に不正性器出血が出現し, 子宮体部にT2, high intensityな腫瘤を認め, 経腟的子宮内腫瘍生検により移行上皮癌G2で膀胱子宮転移と診断した。年齢, 本人の希望により放射線療法単独(腟内照射+全骨盤外照射60Gy)による治療を行い照射後4ヵ月経過して, 膀胱内再発はなく子宮内腫瘤も増大を認めていない。

We report a rare case of uterine corpus metastasis from superficial bladder cancer. A 78-year-old female presented with abnormal vaginal bleeding. She received transurethral resection of bladder tumor (TUR-Bt) two years previously, and the pathological findings were transitional cell carcinoma (TCC) grade 3 pT1. Eight courses of BCG instillation were performed postoperatively. There was no recurrence of bladder cancer when vaginal bleeding occurred. Cytology of vaginal discharge was class V, and transitional cell carcinoma suspected. Pathological finding of transvaginal uterine corpus biopsy was TCC. We diagnosed metastases to uterine corpus from bladder cancer.