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为什么盆腔残端复发性宫颈癌会被误诊为间质性膀胱炎?:基于一例病例报告的泌尿外科医生观点。

Why are recurrent cervical cancers of the pelvic stump misdiagnosed as interstitial cystitis?: The urologist's point of view based on a case report.

作者信息

Oh Jin Kyu, Kim Khae-Hawn

机构信息

Department of Urology, Gachon University Gil Hospital, Incheon, Korea.

出版信息

Can Urol Assoc J. 2013 May-Jun;7(5-6):E359-62. doi: 10.5489/cuaj.1218.

Abstract

A 50-year-old female who had undergone laparoscopic total hysterectomy at a local clinic owing to leiomyoma of the uterus was referred to our hospital after having dysuria, urgency, frequency, lower abdominal pain and right flank pain over several months. After routine examinations, cystoscopy, computed tomography and magnetic resonance imaging were performed, and non-ulcerative interstitial cystitis accompanied by postoperative fibrosis secondary to a previous surgery was suggested. Pentosan sulfuric polyester (Elmiron, Alza Pharmaceuticals, Mountain View, CA) reduced her severely debilitating symptoms and improved her quality of life. Both the hydronephrosis and the symptoms were relieved by ureteral stent insertion and percutaneous nephrostomy. However, a few days later, she presented with vaginal bleeding along with her previous symptoms, and punch biopsy of the vaginal stump resulted in a diagnosis of adenocarcinoma. Both ureterocutaneostomy with radical cystectomy and lower anterior resection for rectum invasion were conducted. After the slide review of the original specimen from the local clinic, she was diagnosed with recurrent cervical cancer of the vaginal stump.

摘要

一名50岁女性因子宫肌瘤在当地诊所接受了腹腔镜全子宫切除术,在经历数月的排尿困难、尿急、尿频、下腹痛和右侧腰痛后转诊至我院。经过常规检查后,进行了膀胱镜检查、计算机断层扫描和磁共振成像,提示为非溃疡性间质性膀胱炎,伴有既往手术继发的术后纤维化。聚多卡醇硫酸聚酯(爱泌罗,阿尔扎制药公司,加利福尼亚州山景城)减轻了她严重的衰弱症状,提高了她的生活质量。输尿管支架置入术和经皮肾造瘘术缓解了肾积水和症状。然而,几天后,她出现阴道出血并伴有先前症状,阴道残端穿刺活检诊断为腺癌。进行了输尿管皮肤造口术加根治性膀胱切除术以及针对直肠侵犯的低位前切除术。在对当地诊所的原始标本进行玻片复查后,她被诊断为阴道残端复发性宫颈癌。

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本文引用的文献

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The interstitial cystitis symptom index and problem index.间质性膀胱炎症状指数与问题指数。
Urology. 1997 May;49(5A Suppl):58-63. doi: 10.1016/s0090-4295(99)80333-1.
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The masquerade of bladder cancer in situ as interstitial cystitis.
J Urol. 1974 Feb;111(2):160-1. doi: 10.1016/s0022-5347(17)59915-2.

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