Yu Jian, Sun Zhi-xi, Kong Chui-ze, Du Shu-qi
Department of Urology, First Affiliated Hospital of China Medical University, Shenyang 110001, China.
Zhonghua Wai Ke Za Zhi. 2009 Sep 15;47(18):1400-2.
To investigate the clinical manifestation, biological behavior, diagnosis and treatment of the urothelial inverted papilloma.
Sixty-two cases of urothelial inverted papilloma were analyzed retrospectively from January 1990 to August 2008. Of the 62 patients, 51 were men and 11 were women. The average age at presentation was 56.4 years old. Fifty-six cases were solitary tumors and 6 were multiple. The most common compliant was macroscopic hematuria. The tumor located at the ureter in 5 cases. Of these cases, 4 were treated by local excision, 1 by nephroureterectomy. One case of multiple ureteral inverted papilloma with coexistent bladder inverted papilloma was treated by total cystectomy. The tumor located at the bladder in 52 cases, with 44 treated by transurethral resection of bladder tumor, 6 by partial cystectomy, 2 by total cystectomy. Four cases had the tumor located at the urethra, with 1 treated by transurethral resection of tumor, 3 by tumorectomy.
The postoperative pathological diagnosis of all the 62 cases was inverted papilloma, synchronous urothelial carcinoma in 7. Follow-up data were available in 49 cases. Two cases had a recurrence at 7 months and 79 months, respectively. Three case of subsequent transitional cell carcinoma developed 18 months, 2 years and 6 years later, respectively.
Inverted urothelial papilloma is a kind of benign tumor. It should be differentiated from malignant urothelial tumors. Surgical operation is the main treatment choice. Cystoscopic surveillance and followup are necessary after the operation regularly.
探讨膀胱尿路上皮内翻性乳头状瘤的临床表现、生物学行为、诊断及治疗方法。
回顾性分析1990年1月至2008年8月收治的62例膀胱尿路上皮内翻性乳头状瘤患者的临床资料。62例患者中,男51例,女11例,平均发病年龄56.4岁。单发肿瘤56例,多发肿瘤6例。最常见的症状为肉眼血尿。肿瘤位于输尿管5例,其中4例行局部切除,1例行肾输尿管切除术。1例多发输尿管内翻性乳头状瘤合并膀胱内翻性乳头状瘤患者行全膀胱切除术。肿瘤位于膀胱52例,其中44例行经尿道膀胱肿瘤切除术,6例行膀胱部分切除术,2例行全膀胱切除术。肿瘤位于尿道4例,其中1例行经尿道肿瘤切除术,3例行肿瘤切除术。
62例患者术后病理诊断均为内翻性乳头状瘤,7例同时合并尿路上皮癌。49例患者获得随访,2例分别于术后7个月和79个月复发。3例患者分别于术后18个月、2年和6年发生继发性移行细胞癌。
膀胱尿路上皮内翻性乳头状瘤是一种良性肿瘤,应与恶性尿路上皮肿瘤相鉴别,手术治疗是主要的治疗方法,术后需定期行膀胱镜检查及随访。