Kawamura Norihiko, Hatano Koji, Kakuta Yoichi, Takada Tsuyoshi, Hara Tsuneo, Yamaguchi Seiji
The Department of Urology, Ikeda Municipal Hospital.
Hinyokika Kiyo. 2009 Oct;55(10):619-22.
A 79-year-old man was admitted to our hospital with a chief complaint of pollakisuria. He was diagnosed as having bladder tumors and bladder stone by cystoscopy. Transurethral resection of bladder tumors (TURBT) and transurethral cystolithotripsy were performed and histology revealed non-muscle-invasive hepatoid adenocarcinoma that produced alpha-fetoprotein (AFP) and urothelial carcinoma. The serum AFP level was present at a high level of 39.08 ng/ml. After five months' follow up, recurrent tumor were detected in the bladder. TURBT was performed and the pathologic finding showed non-muscle-invasive (not hepatoid) adenocarcinoma that produced AFP. After eight months' follow up, a recurrent tumor was detected in the bladder again. TURBT was performed and the pathologic finding showed non-muscle-invasive urothelial carcinoma. However, the serum AFP level remained above 35 ng/ml. After the 3rd TURBT, intravesical intillations were performed, which led to a normalization of the serum AFP level. Nineteen months after his final hospitalization, the patient has had no evidence of recurrence.
一名79岁男性因尿频为主诉入院。经膀胱镜检查诊断为膀胱肿瘤和膀胱结石。行经尿道膀胱肿瘤切除术（TURBT）和经尿道膀胱碎石术，组织学检查显示为产生甲胎蛋白（AFP）的非肌层浸润性肝样腺癌和尿路上皮癌。血清AFP水平高达39.08 ng/ml。经过五个月的随访，膀胱内检测到复发性肿瘤。再次进行TURBT，病理结果显示为产生AFP的非肌层浸润性（非肝样）腺癌。经过八个月的随访，膀胱内再次检测到复发性肿瘤。再次进行TURBT，病理结果显示为非肌层浸润性尿路上皮癌。然而，血清AFP水平仍高于35 ng/ml。第三次TURBT后，进行了膀胱内灌注，这使得血清AFP水平恢复正常。在他最后一次住院19个月后，患者没有复发迹象。
