Department of Urology, University Medical Centre Utrecht (UMC Utrecht), Heidelberglaan 100, Huispostnr. C.04.236, 3584 CX Utrecht, The Netherlands.
Int Urol Nephrol. 2012 Aug;44(4):1027-30. doi: 10.1007/s11255-011-0046-3. Epub 2011 Aug 26.
We present the case of a 31-year-old spina bifida patient presenting with a poorly differentiated T3N1M0 bladder carcinoma with sarcomatoid differentiation in an auto-augmented bladder. She underwent a radical cystectomy and a bilateral lymph node dissection. However, only 10 months after the onset of her symptoms, she died after major lymphatic metastases had developed in the small pelvis. This case report is the first on an adult spina bifida patient developing bladder carcinoma after detrusorectomy. It shows that bladder cancer also occurs in patients who underwent detrusorectomy, despite the fact that the risk is supposedly lower than in patients who underwent enterocystoplasty. Moreover, tumour spread to adjacent organs could occur more rapidly in auto-augmented bladders because of the lack of muscle tissue. The latter could have serious implications on the prognosis of these patients.
我们报告了一例 31 岁的脊柱裂患者，其在自体增强膀胱中出现分化不良的 T3N1M0 膀胱癌伴肉瘤样分化。她接受了根治性膀胱切除术和双侧淋巴结清扫术。然而，在症状出现仅 10 个月后，她死于小骨盆内发生重大淋巴转移。该病例报告是首例成年脊柱裂患者在进行逼尿肌切除术后发生膀胱癌。它表明，即使风险低于接受肠膀胱成形术的患者，接受逼尿肌切除术的患者也会发生膀胱癌。此外，由于缺乏肌肉组织，自体增强膀胱中肿瘤向邻近器官扩散的速度可能更快。这可能对这些患者的预后产生严重影响。
