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膀胱癌肉瘤:病例报告及文献综述

Carcinosarcoma of the bladder: case report and review of the literature.

作者信息

Akoluk Arda, Barazani Yagil, Slova Denisa, Shah Sovrin, Tareen Basir

机构信息

Yeditepe University School of Medicine, Istanbul,Turkey.

出版信息

Can Urol Assoc J. 2011 Aug;5(4):E69-73. doi: 10.5489/cuaj.10161.

Abstract

Primary osteosarcomas of the bladder account for about 0.04% of bladder neoplasms. Most of the patients in the literature expired within 6 months and, in almost all of the cases in the literature, radical cystectomy with postoperative chemotherapy was the treatment choice. A 79-year-old gentleman presented with gross hematuria. Cystoscopy demonstrated a 2- to 3-cm tumour along the lateral wall of the bladder. The tumour was resected incompletely via initial transurethral resection of bladder tumour (TURBT), and a second TURBT was subsequently performed to fully resect the residual mass. Surgical pathology from these 2 resections revealed osteosarcoma with invasion into the muscularis propria. A cystoprostatectomy was performed and final pathologic specimen revealed high-grade CIS without evidence of residual osteosarcoma. Postoperatively, the patient did not receive chemotherapy or radiation and currently remains disease-free 2 years post-radical cystectomy. Only 33 well-documented cases of primary osteosarcoma of the bladder have been reported to date. However, there are only 3 cases in which TURBT resulted in complete resection.

摘要

膀胱原发性骨肉瘤约占膀胱肿瘤的0.04%。文献中的大多数患者在6个月内死亡,并且在文献报道的几乎所有病例中,治疗选择都是根治性膀胱切除术加术后化疗。一名79岁男性因肉眼血尿就诊。膀胱镜检查发现膀胱侧壁有一个2至3厘米的肿瘤。最初通过经尿道膀胱肿瘤切除术(TURBT)对肿瘤进行了不完全切除,随后又进行了第二次TURBT以完全切除残留肿块。这两次切除的手术病理显示为骨肉瘤,侵犯至固有肌层。进行了膀胱前列腺切除术,最终病理标本显示为高级别原位癌,无残留骨肉瘤证据。术后,患者未接受化疗或放疗,目前在根治性膀胱切除术后2年仍无疾病。迄今为止,仅报道了33例有充分记录的膀胱原发性骨肉瘤病例。然而,只有3例经TURBT实现了完全切除。

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