McArdle Brian J, Vidal Patricia, Psutka Sarah P, Hollowell Courtney M P
Division of Urology, Department of Surgery, Cook County Health and Hospitals System, Chicago, Illinois, USA.
Can J Urol. 2018 Feb;25(1):9214-9216.
It is rare to see an adult presenting with exstrophy of the bladder. Malignant conversion in exstrophy occurs in 4%, with adenocarcinoma as the most common histopathology. We report the first case of metastatic high grade urothelial carcinoma with squamous and sarcomatoid differentiation arising from undiagnosed, closed bladder exstrophy in a female at advanced age with associated bilateral deep vein thrombosis and clot retention. The patient developed clinical progression of disease despite neoadjuvant gemcitabine-cisplatin and salvage (or palliative) radiotherapy. To the best of our knowledge, this is the first reported case of a primary urothelial malignancy in occult bladder exstrophy.
成年膀胱外翻患者较为罕见。膀胱外翻发生恶性转化的比例为4%，其中腺癌是最常见的组织病理学类型。我们报告了首例转移性高级别尿路上皮癌病例，该病例起源于一名老年女性未被诊断出的闭合性膀胱外翻，伴有鳞状和肉瘤样分化，同时合并双侧深静脉血栓形成和血块潴留。尽管患者接受了新辅助吉西他滨-顺铂化疗和挽救性（或姑息性）放疗，但疾病仍出现了临床进展。据我们所知，这是首例关于隐匿性膀胱外翻中原发性尿路上皮恶性肿瘤的报道病例。
