Warne Richard R, Ong Jeremy S L, Snowball Bret, Vivian Justin B
Department of Radiology, Royal Perth Hospital, Perth, Western Australia, Australia.
BMJ Case Rep. 2011 Apr 1;2011:bcr1120103484. doi: 10.1136/bcr.11.2010.3484.
Our case report pertains to a 32-year-old woman initially presenting with left flank pain and gross haematuria throughout her urinary stream. CT of her kidney/ureter/bladder (CT KUB) revealed ureteric dilatation to the level of the bladder without evidence of renal calculus and subsequently a stent was inserted. She represented a month later with contralateral flank pain, and a transuretheral resection of bladder tumour was performed. Histopathological diagnosis was epithelioid angiosarcoma. Further imaging (MRI pelvis) revealed that the tumour arose from the posterior bladder wall with local invasion and regional lymph node metastasis. Ifosfamide and epirubicin chemotherapy with single-fraction radiotherapy induced significant reduction in tumour bulk, although this initial response was followed by the development of symptoms suggestive of disease progression. She died 19 months after initial diagnosis with persistent pulmonary and vertebral metastases although no autopsy was performed.
我们的病例报告涉及一名32岁女性，最初表现为左侧胁腹疼痛及全程肉眼血尿。其肾脏/输尿管/膀胱CT（CT KUB）显示输尿管扩张至膀胱水平，未发现肾结石，随后插入了支架。一个月后她因对侧胁腹疼痛再次就诊，接受了经尿道膀胱肿瘤切除术。组织病理学诊断为上皮样血管肉瘤。进一步的影像学检查（盆腔MRI）显示肿瘤起源于膀胱后壁，伴有局部侵犯和区域淋巴结转移。异环磷酰胺和表柔比星化疗联合单次分割放疗使肿瘤体积显著缩小，尽管最初的反应之后出现了提示疾病进展的症状。她在初次诊断19个月后死于持续性肺和脊柱转移，尽管未进行尸检。
