膀胱小細胞癌の3例

Abstract

症例1(69歳男性)。13年前に膀胱癌(CIS)に対するBCG膀胱内注入療法が施行され, 約9ヵ月前より前立腺癌に対し内分泌療法が開始されたが, 顕微鏡的血尿が出現した。症例2(83歳女性)。肉眼的血尿を主訴とした。症例3(84歳男性)。無症候性肉眼的血尿を主訴とした。いずれの症例も膀胱鏡にて膀胱左壁または右壁に非乳頭状広基性腫瘍が認められ, TURBTが行われた。その結果, 3症例とも病理組織学的に膀胱小細胞癌であった。症例1はpT2N0M0にてirinotecan+carboplatinによる化学療法を3コース施行し, CRが得られたが, 化学療法終了16ヵ月後に前立腺癌の悪化のため死亡となった。症例2はpT2N0M0にて膀胱部分切除術を施行し, 術後6ヵ月経過で再発転移はみられていない。症例3はcT3bN0M1にてetoposide+carboplatinによる化学療法を4コース施行したところ, 腫瘍は縮小し, 現在は経過観察中である。

We report three cases of small cell carcinoma of the urinary bladder. Case 1: A 69-year-old man showed microscopic hematuria during follow up of prostate cancer of stage D2. The patient was diagnosed with small cell carcinoma of the urinary bladder at the stage of pT2N0M0. Complete remission was achieved by three courses of chemotherapy consisting of irinotecan and carboplatin. The patient was died by prostate cancer 16 months after the chemotherapy. Case 2: An 83-year-old woman presented with macroscopic hematuria. The patient was diagnosed with small cell carcinoma of the urinary bladder at the stage of pT2N0M0 and partial cystectomy was performed. The patient has been alive without any evidence of tumor recurrence at 6 months after surgery. Case 3: An 84-year-old man presented with macroscopic hematuria. The patient was diagnosed with small cell carcinoma of the urinary bladder at the stage ofcT3bN0M1 with multiple liver metastases. Complete remission was achieved by three courses of chemotherapy consisting of etoposide and carboplatin.