Kassam Shaqil N, Aziz Zared, Hung Lick San, Sridhar Srikala S
Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto, ON;
Can Urol Assoc J. 2013 May-Jun;7(5-6):E376-80. doi: 10.5489/cuaj.1223.
We present the case of a 53-year-old man with a 25-pack/year smoking history and a 6-month history of gross hematuria, who presented with a pT3a, N0, M0, muscle invasive bladder cancer (MIBC). He declined neoadjuvant chemotherapy, but received post-cystectomy adjuvant chemotherapy. Six months post-adjuvant chemotherapy, he presented with abdominal pain and a large bowel obstruction, and was found to have an isolated rectal recurrence of MIBC. This case illustrates 2 important issues: (1) patients with a smoking history and symptoms of hematuria need to be carefully evaluated to rule out urothelial cancer; and (2) in patients with muscle invasive disease, local pelvic recurrence is common and close surveillance for recurrence needs to be implemented.
我们报告了一例53岁男性患者，有25年的吸烟史，肉眼血尿6个月，诊断为pT3a、N0、M0期肌层浸润性膀胱癌（MIBC）。他拒绝新辅助化疗，但接受了膀胱切除术后辅助化疗。辅助化疗6个月后，他出现腹痛和大肠梗阻，发现存在MIBC孤立性直肠复发。该病例说明了两个重要问题：（1）有吸烟史和血尿症状的患者需要仔细评估以排除尿路上皮癌；（2）对于肌层浸润性疾病患者，盆腔局部复发很常见，需要对复发进行密切监测。
