Yoshida Yasuyuki, Yamanaka Kazuaki, Ueda Norichika, Hirai Toshiaki, Kishikawa Hidefumi, Nishimura Kenji, Ichikawa Yasuji
The Department of Urology, Hyogo Prefectural Nishinomiya Hospital.
The Department of Specific Organ Regulation (Urology), Osaka University.
Hinyokika Kiyo. 2014 Mar;60(3):147-50.
A 67-year-old woman presented with macroscopic hematuria and lower abdominal pain. Cystoscopy revealed a broad-stalk non-papillary tumor at the bladder dome. Computed tomography (CT) showed a tumor extending from the umbilicus to the bladder dome, together with multiple lung metastases. Serum carcinoembryonic antigen and cancer antigen (CA19-9) levels were elevated at 7.0 ng/ml and 180 U/ml, respectively. Transurethral resection of the tumor was performed and histopathology revealed adenocarcinoma. Therefore, the tumor was diagnosed as a stage IVB (Sheldon's category) urachal carcinoma. En bloc segmental resection of the urachal carcinoma with the bladder dome was performed, followed by chemotherapy with tegafur, gimestat, and otastat potassium (TS-1) and cisplatin. The disease remained stable for 8 months. However, a follow up CT scan after 11 chemotherapy cycles showed progression of the lung metastases. In spite of the change to a second-line gemcitabine and cisplatin chemotherapy regimen, the disease continued to progress after 4 cycles.
一名67岁女性因肉眼血尿和下腹部疼痛就诊。膀胱镜检查发现膀胱顶部有一个宽蒂非乳头状肿瘤。计算机断层扫描（CT）显示肿瘤从脐部延伸至膀胱顶部，并伴有多处肺转移。血清癌胚抗原和癌抗原（CA19-9）水平分别升高至7.0 ng/ml和180 U/ml。进行了经尿道肿瘤切除术，组织病理学显示为腺癌。因此，该肿瘤被诊断为IVB期（谢尔登分类）脐尿管癌。对脐尿管癌连同膀胱顶部进行了整块节段性切除，随后用替加氟、吉美嘧啶和奥替拉西钾（TS-1）和顺铂进行化疗。病情稳定了8个月。然而，在11个化疗周期后的随访CT扫描显示肺转移进展。尽管改用了二线吉西他滨和顺铂化疗方案，但在4个周期后病情仍继续进展。
