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膀胱保留治疗后出现伴有良性活检灶的欺骗性肌层浸润性膀胱癌复发。

Deceptive muscle invasive bladder cancer recurrence with benign biopsy foci after bladder sparing treatment.

作者信息

Xu Chuanliang, Zeng Shuxiong, Zhang Zhensheng, Song Ruixiang, Ma Chong, Chen Xin, Sun Yinghao

机构信息

From the Department of Urology, Changhai Hospital, Second Military Medicalv University, Shanghai, P. R. China (CX, SZ, ZZ, RS, CM, XC, YS).

出版信息

Medicine (Baltimore). 2015 Jun;94(22):e898. doi: 10.1097/MD.0000000000000898.

Abstract

Most of recurrent bladder carcinoma after partial cystectomy did not cause diagnostic difficulties for urologists, because of the appearance of typical papillary in ultrasonography or cystoscopy, and could be easily confirmed by tumor biopsy. Three patients, ages from 35 to 62 years, had undergone bladder sparing treatment for muscle invasive bladder cancer, all of them had biopsy revealed benign bladder lesion at surveillance cystoscopy. However, transurethral resection of bladder tumor showed high-grade muscle invasive urothelial bladder carcinoma for these patients. Two patients were thus delayed for timely cystectomy and consequently resulted in local or distal metastasis.As a result, we recommended that timely pelvic enhanced computed tomography and transurethral resection of bladder tumor were necessary when bladder lesion occurred after partial cystectomy, avoiding the possibility of missing muscle invasive urothelial bladder carcinoma recurrence and delaying timely cystectomy.

摘要

大部分膀胱部分切除术后复发性膀胱癌对泌尿外科医生来说诊断并不困难,因为超声或膀胱镜检查可见典型的乳头状外观,且通过肿瘤活检很容易确诊。3例年龄在35至62岁之间的患者曾接受保留膀胱治疗肌肉浸润性膀胱癌,在监测膀胱镜检查时,所有患者的活检均显示为良性膀胱病变。然而,经尿道膀胱肿瘤切除术显示这些患者为高级别肌肉浸润性膀胱尿路上皮癌。因此,2例患者延误了及时行膀胱切除术,结果导致局部或远处转移。因此,我们建议在膀胱部分切除术后出现膀胱病变时,及时进行盆腔增强计算机断层扫描和经尿道膀胱肿瘤切除术,以避免漏诊肌肉浸润性膀胱尿路上皮癌复发并延误及时行膀胱切除术的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e798/4616362/616e27754c72/medi-94-e898-g002.jpg

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