膀胱小細胞癌の1例

Abstract

69歳女性。患者は尿路上皮癌を繰り返し治療経過中であったが, 肉眼的血尿が出現し, 精査加療目的に著者らの施設へ入院となった。画像所見では膀胱内に腫瘍の再発がみられ, 生検結果はUC, pT2N0M0であった。治療として膀胱全摘出術および回腸導管造設術を施行したところ, 病理組織学的・免疫染色では膀胱小細胞癌であり, 更に化学療法を予定したが, 術後イレウスを繰り返し, 全身状態が不安定であったため, 一旦退院とした。以後, 2ヵ月経過で多発性の肝転移, 脊椎転移を認め, 患者は全身状態が悪化し, 術後67日目に死亡となった。

A 69 year-old woman visited our hospital with a chief complaint of macrohematuria in April 2004. She was diagnosed with bladder tumor. She underwent transurethral resection ofbladdar tumor three times and right partial ureterectomy for ureteral tumor following primary bladder carcinoma. All pathological findings demonstrated that the tumor was urothelial carcinoma (UC), G1-G2, pT1 including right ureteral tumor. In spite of intravesical instillation of BCG, recurrent invasive bladder tumor was found in June 2006. In July 2006, we performed total cystectomy and construction of ileal conduit. Surgical specimen revealed small cell carcinoma and immunohistochemical staining with NSE and synaptophysin was positive. On day 67 after operation, the patient died of multiple metastases to liver and bone.