化学療法が奏効した尿膜管癌術後多発肺転移の1例

Abstract

A 39-year-old man visited our clinic with gross hematuria. Cystoscopy revealed a papillary tumor at the urinarybladder dome. Abdominal magnetic resonance imaging (MRI) and computed tomography(CT) demonstrated a tumor extending from the umbilicus to the bladder dome. Transurethral resection of bladder tumor (TUR-Bt) was performed and histopathological findings revealed adenocarcinoma. Chest CT and examination of the upper gastrointestinal did not reveal anyabnormal findings. The tumor was diagnosed as stage IIIA urachal carcinoma, and en bloc segmental resection was performed. About 10 months later, chest CT demonstrated multiple lung metastases. After two courses of combination chemotherapywith methotrexate (MTX), 5-fluorouracil (5-FU), epirubicin (epiADM), and cisplatin (CDDP), the multiple lung metastases completelydisappeared. The patient has survived 23 months to date with no evidence of disease and is receiving adjuvant chemotherapywith tegafur uracil.