Masuda A, Minakmi S, Usui Y, Arihara K, Nagata Y, Kawamura N
Department of Urology, Tokai University School of Medicine, Tokai University Oiso Hospital, Kanagawa, Japan.
Tokai J Exp Clin Med. 2001 Jul;26(2):39-43.
We present a rare case of advanced bladder cancer in a young female. A 27-year-old woman had the chief complaint of proteinuria. A clinical examination revealed a papillary, broad-based bladder tumor with a clinical stage of T3, N3, M0. Preoperatively, 3 courses of neoadjuvant chemotherapy with methotrexate, adriamycin, and cisplatin were performed, and proved to be effective. Radical cystectomy was done and the histopathologically it was diagnosis as Grade 2 transitional cell carcinoma, which did not show any p53 gene mutation. The patient's postoperative clinical course was uneventful, and she remained disease free for 27 months. Bladder carcinoma in patients under 30 years of age tends to have a early stage and a low grade. However, the above described 27-year-old female patient demonstrated the advanced stage bladder tumor. Therefore, it should be kept in mind to accurately evaluate young patients with transitional cell carcinoma of the bladder and not to rule out the possibility of advanced disease even though a patient is young.
我们报告一例年轻女性晚期膀胱癌的罕见病例。一名27岁女性以蛋白尿为主诉。临床检查发现一个乳头状、基底较宽的膀胱肿瘤,临床分期为T3、N3、M0。术前采用甲氨蝶呤、阿霉素和顺铂进行了3个疗程的新辅助化疗,结果证明有效。进行了根治性膀胱切除术,组织病理学诊断为2级移行细胞癌,未显示任何p53基因突变。患者术后临床过程平稳,无病生存27个月。30岁以下患者的膀胱癌往往处于早期且分级较低。然而,上述27岁女性患者表现为晚期膀胱肿瘤。因此,应牢记要准确评估年轻的膀胱移行细胞癌患者,即使患者年轻也不能排除晚期疾病的可能性。