Yasui Masato, Jikuya Ryosuke, Tatenuma Tomoyuki, Muraoka Kentaro, Umemoto Susumu, Kawai Masaki, Kouno Tsutomu, Kishida Takeshi
Department of Urology, Kanagawa Cancer Center, Yokohama, Japan.
Department of Medical Oncology, Sasaki Foundation Kyoundo Hospital, Tokyo, Japan.
Case Rep Urol. 2018 Jun 13;2018:9836154. doi: 10.1155/2018/9836154. eCollection 2018.
A 56-year-old man was admitted to our hospital for urachal carcinoma with peritoneal dissemination. He received first-line chemotherapy with gemcitabine and cisplatin. After the fifth cycle, a computed tomography (CT) scan revealed abdominal fluid, and his serum tumor marker levels were increased. The patient was started on second-line therapy with FOLFIRI. After 11 cycles, his tumor decreased in size and no new metastatic lesions were detected. The patient underwent complete tumor resection with partial cystectomy and pelvic lymph node dissection. The tumor was removed, along with adhering surrounding organs, including the omentum, peritoneum, abdominal rectus muscle, and vermiform appendix. Although pathological examination confirmed peritoneal dissemination, his tumor markers normalized soon after surgery. The patient has survived 62 months after surgery without any adjuvant therapy and with no evidence of recurrence. To our knowledge, this is the longest duration of survival without recurrence of a patient with urachal carcinoma with peritoneal dissemination who received multimodal therapy.
一名56岁男性因脐尿管癌伴腹膜播散入住我院。他接受了吉西他滨和顺铂的一线化疗。在第五个周期后，计算机断层扫描（CT）显示有腹腔积液，且他的血清肿瘤标志物水平升高。该患者开始接受FOLFIRI二线治疗。11个周期后，他的肿瘤体积缩小，未检测到新的转移病灶。患者接受了包括部分膀胱切除术和盆腔淋巴结清扫术的肿瘤完全切除术。肿瘤连同粘连的周围器官，包括大网膜、腹膜、腹直肌和阑尾一并切除。尽管病理检查证实有腹膜播散，但他的肿瘤标志物在手术后很快恢复正常。该患者在未接受任何辅助治疗的情况下术后存活了62个月，且无复发迹象。据我们所知，这是接受多模式治疗的脐尿管癌伴腹膜播散患者无复发存活的最长时间。
