Isono Makoto, Ito Keiichi, Hamada Shinsuke, Takahashi Masahiro, Sasa Hidenori, Shimazaki Hideyuki, Asano Tomohiko
Department of Urology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan.
Department of Obstetrics and Gynecology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan.
Case Rep Urol. 2018 Oct 24;2018:3069294. doi: 10.1155/2018/3069294. eCollection 2018.
Small cell carcinoma (SCC) of the urinary bladder is highly aggressive and portends a poor outcome. Herein, we report a patient with recurrent SCC of the urinary bladder who experienced an unusually long-term disease-free duration after radical cystectomy. The patient was a 60-year-old woman who had undergone transurethral resection followed by radical cystectomy for muscle-invasive bladder cancer (high-grade urothelial carcinoma with adenocarcinomatous differentiation) 6 years prior; the surgical specimen had a negative surgical margin. She was referred to our hospital because of continuous bleeding from her vagina. Magnetic resonance imaging showed a mass located at the anterior wall of her residual vagina, a biopsy of which confirmed a pathological diagnosis of adenocarcinoma. The vaginal tumor and a section of the sigmoid colon were resected and were pathologically diagnosed as adenocarcinoma and SCC. We reevaluated the initial transurethral resection specimen and found SCC with foci of adenocarcinoma concomitant with high-grade urothelial carcinoma. Local recurrence and metastasis at the pelvic bone occurred 4 months later; although radiation therapy was performed, she died of the progressive disease.
膀胱小细胞癌（SCC）具有高度侵袭性，预后较差。在此，我们报告一例复发性膀胱SCC患者，该患者在根治性膀胱切除术后经历了异常长的无病生存期。患者为60岁女性，6年前因肌层浸润性膀胱癌（伴有腺癌分化的高级别尿路上皮癌）接受了经尿道切除术，随后进行了根治性膀胱切除术；手术标本切缘阴性。她因阴道持续出血转诊至我院。磁共振成像显示残留阴道前壁有一肿块，活检证实为腺癌的病理诊断。切除了阴道肿瘤和一段乙状结肠，病理诊断为腺癌和SCC。我们重新评估了最初的经尿道切除标本，发现SCC伴有腺癌灶，同时合并高级别尿路上皮癌。4个月后出现盆腔骨局部复发和转移；尽管进行了放射治疗，但她最终死于疾病进展。
