Di Lauro Giovanni, Iacono Fabrizio, Ruffo Antonio, Romis Leo, Mordente Salvatore, Pane Umberto, Illiano Ester, Romeo Giuseppe, Prezioso Domenico, Amato Bruno
BMC Surg. 2013;13 Suppl 2(Suppl 2):S36. doi: 10.1186/1471-2482-13-S2-S36. Epub 2013 Oct 8.
Bladder exstrophy occurs in approximately 1 in 35,000 live births and is associated with an increased incidence of bladder cancer.
A 55-year old male patient was diagnosed with a primary mucinous adenocarcinoma of an unreconstructed exstrophic bladder. Examination of the entire gastrointestinal tract shown there were not other primary cites. Immunohistochemistry confirmed the nature of the tumour. The patient underwent a radical cystoprostatectomy with en block bilateral pelvic lymphadenectomy, urinary diversion with a cutaneous ureterostomy and epidpadias repair.
Adult bladder exstrophy and epispadia correction is a very rare practice in urology due the fact that this congenital disease is diagnosed and corrected in neonates. We advocate the radical surgical management, after exclusion of any primary malignant sites related to the gastrointestinal tract.
膀胱外翻在大约每35000例活产婴儿中出现1例,并且与膀胱癌发病率增加相关。
一名55岁男性患者被诊断为未重建的外翻膀胱原发性黏液腺癌。对整个胃肠道的检查显示没有其他原发部位。免疫组织化学证实了肿瘤的性质。该患者接受了根治性膀胱前列腺切除术并整块切除双侧盆腔淋巴结清扫术,采用皮肤输尿管造口术进行尿流改道以及阴茎头型尿道上裂修复。
由于这种先天性疾病在新生儿期就被诊断并矫正,因此成人膀胱外翻和尿道上裂矫正在泌尿外科是非常罕见的手术。我们主张在排除任何与胃肠道相关的原发性恶性部位后,采取根治性手术治疗。