Katayama Hiromichi, Mituzuka Koji, Kawasaki Yoshihide, Kato Shinnosuke
Department of Urology, Ogachi-Chuo Hospital.
Hinyokika Kiyo. 2010 Apr;56(4):229-31.
A 64-year-old man was referred to our hospital with chief complaints of gross hematuria and pollakisuria. Cystoscopic examination showed non-papillary broad basis tumor on the left lateral wall involving the left ureteral orifice. Computed tomography (CT) and magnetic resonance imaging revealed left hydronephrosis and urinary bladder tumor which extended outside of the bladder wall. Transurethral biopsy showed grade 3 urothelial carcinoma with glandular differentiation including signet ring cells. Radical cystectomy, left nephrureterectomy and right ureterocutaneostomy were performed. Pathological examination showed urothelial carcinoma; pT3aN0. Lymph node metastasis occurred five months later. Three courses of M-VAC chemotherapy (methotrexate, vinblastine, adriamycin, cisplatin) were done with little effectiveness. Sixteen months after the operation, he complained of anorexia and tenesmus, and CT showed annular thickening of the rectal wall. A fecal diversion was performed, but he died two months later.
一名64岁男性因肉眼血尿和尿频被转诊至我院。膀胱镜检查显示左侧壁有非乳头状广基肿瘤，累及左输尿管口。计算机断层扫描（CT）和磁共振成像显示左肾积水和膀胱肿瘤，肿瘤已延伸至膀胱壁外。经尿道活检显示为3级伴腺性分化的尿路上皮癌，包括印戒细胞。行根治性膀胱切除术、左肾输尿管切除术和右输尿管皮肤造口术。病理检查显示为尿路上皮癌；pT3aN0。五个月后发生淋巴结转移。进行了三个疗程的M-VAC化疗（甲氨蝶呤、长春碱、阿霉素、顺铂），但效果不佳。术后16个月，他出现厌食和里急后重，CT显示直肠壁环形增厚。进行了粪便改道，但两个月后他去世了。
