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Title: CPT-11とCDDPによるNeo-adjuvant化学療法を施行した膀胱原発小細胞癌の1例
Other Titles: Small cell carcinoma of the urinary bladder treated with neo-adjuvant cp chemotherapy (CPT-11 and CDDP): a case report
Authors: 船橋, 亮  KAKEN_name
山田, 哲夫  KAKEN_name
村山, 鐵郎  KAKEN_name
Author's alias: Funahashi, Makoto
Yamada, Tetsuo
Murayama, Tetsuo
Keywords: Bladder
Small cell carcinoma
Issue Date: Feb-2007
Publisher: 泌尿器科紀要刊行会
Journal title: 泌尿器科紀要
Volume: 53
Issue: 2
Start page: 129
End page: 132
Abstract: 68歳男。無症候性肉眼的血尿が出現し, 膀胱鏡で頂部に非乳頭状腫瘍を認めた。骨盤MRIのT2強調像では低信号を示し, 筋層を越える浸潤を疑った。staging TUR-BTを施行し, 病理所見で一部にTCC, grade 2~3を認めたが, クロマチンに富む類円形・紡錘形の核を持つ細胞質に乏しい腫瘍細胞が充実性に増殖する像を呈し, シナプトフィジン抗体染色で褐色に染まる細胞を多数認め, 小細胞癌の所見であった。深達度はpT2以上で, 腫瘍マーカーは基準値内であった。肺小細胞癌のプロトコールに準じてCPT-11, CDDP併用のCP療法を1コース施行した後, 膀胱尿道全摘術および回腸導管造設術を施行した。摘出標本で膀胱頂部に3.5×2.0cmの瘢痕を, 上皮下に異物巨細胞の集簇を伴う線維化を認めたが, 腫瘍の遺残はなく, その他の膀胱内にも腫瘍は認めなかった。術後adjuvant chemotherapyとしてCP療法を1コース施行した。術後7ヵ月経過し, 再発・転移はない。
We report a cases of primary small cell carcinoma of the urinary bladder. A 68-year-old man was referred to our hospital because of asymptomatic gross hematuria. Cystoscopy showed a solid tumor on the dome of the urinary bladder. Pelvic magnetic resonance imaging (MRI) revealed a mass lesion with extravesical extention, and computed tomography(CT) scan and bone scintigraphy showed no distant metastasis. Transurethral resection of the bladder tumor (TUR-BT) was performed. Histopathological findings of the specimen showed small cell carcinoma (> pT2), with transitional cell carcinoma (TCC), grade 2-3. We performed one course of neoadjuvant CP chemotherapy using Irinotecan (CPT-11) and Cisplatin (CDDP), followed by radical cystectomy. Histopathological finding of the specimen showed no evidence of malignancy. We performed one more course of adjuvant CP chemotherapy. He has been free of disease 7 months after operation.
PubMed ID: 17352165
Appears in Collections:Vol.53 No.2

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