Church E, Dieh A
Pennine Acute Hospitals NHS Trust - Obstetrics and Gynaecology , Lancashire , UK.
Obstet Med. 2013 Dec;6(4):182-3. doi: 10.1258/om.2012.120021. Epub 2013 May 3.
We report a rare case of an aggressive squamous cell carcinoma of the bladder in a young primigravid woman with recurrent urinary tract infections and microscopic haematuria. An emergency caesarean section was performed at 37 weeks gestation for suspected placental abruption; however, she was found to have frank haematuria. Postnatally, an advanced bladder tumour was diagnosed. She required renal dialysis, a radical cystectomy and radiotherapy but sadly died seven months after diagnosis. This case illustrates the importance of thorough investigation of haematuria in pregnancy. Cystoscopy and even tumour resection can be safely performed in pregnancy. Although squamous cell carcinomas account for only 2% of bladder tumours in developed countries, they tend to be large and deeply invasive, requiring radical surgery and chemotherapy or radiotherapy. Management should be multidisciplinary and treatment individualized due to the significant clinical and emotional challenges which arise when a woman develops a malignancy in pregnancy or the puerperium.
我们报告了一例罕见的侵袭性膀胱鳞状细胞癌病例,患者为一名初产妇,年轻女性,有复发性尿路感染和镜下血尿病史。孕37周时因怀疑胎盘早剥行急诊剖宫产;然而,术中发现她有明显血尿。产后诊断为晚期膀胱肿瘤。她需要进行肾透析、根治性膀胱切除术和放疗,但遗憾的是,诊断后七个月死亡。该病例说明了孕期对血尿进行全面检查的重要性。孕期可安全地进行膀胱镜检查甚至肿瘤切除术。虽然在发达国家鳞状细胞癌仅占膀胱肿瘤的2%,但它们往往体积较大且浸润较深,需要根治性手术及化疗或放疗。由于女性在孕期或产褥期发生恶性肿瘤会带来重大的临床和情感挑战,因此管理应多学科协作且治疗个体化。