Suzuki M, Ishimaru H, Noro A, Nakagome K, Andou M, Goto S, Oshima H
Department of Urology, Tokyo Medical and Dental University.
Hinyokika Kiyo. 1992 May;38(5):583-6.
Perineal implantation of urinary bladder cancer in a 57-year-old male is reported. The patient had been suffering from incomplete paraplegia and neurogenic bladder for these 29 years because of accidental injury of lumbar spinal cord with episodes of bladder stones two times and right epididymitis three times, and presented urinary leakage from a perineal fistula. The fistula orifice was surrounded by a hard mass lesion. Bilateral swelling of inguinal lymph nodes was present. Fistulogram and voiding cysto-urethrography revealed reflux from posterior urethra to the fistula through right vas and epididymis. Histological diagnosis of resected perineal mass and biopsied left inguinal lymph node was transitional cell carcinoma with predominant metaplasia of squamous cell carcinoma. Tissues obtained by TUR-biopsy of a mass lesion at bladder wall was also histologically diagnosed transitional cell carcinoma with metaplasia of squamous cell carcinoma. The present case indicates implantation of a bladder tumor to perineum by urethero-vasal reflux and metastases to inguinal lymphnodes from the perineal lesion.
报道了一名57岁男性膀胱肿瘤会阴部种植的病例。该患者因腰脊髓意外损伤，29年来一直患有不完全性截瘫和神经源性膀胱，曾两次发作膀胱结石，三次发作右侧附睾炎，并出现会阴部瘘管漏尿。瘘口被一坚硬肿块病变环绕。双侧腹股沟淋巴结肿大。瘘管造影和排尿性膀胱尿道造影显示后尿道通过右侧输精管和附睾向瘘管反流。切除的会阴部肿块和活检的左侧腹股沟淋巴结组织学诊断为移行细胞癌，以鳞状细胞癌化生为主。经尿道膀胱壁肿块活检获取的组织学诊断也为移行细胞癌伴鳞状细胞化生。本病例表明膀胱肿瘤可通过尿道输精管反流种植至会阴部，并从会阴部病变转移至腹股沟淋巴结。
