Ochi Atsuhiko, Harada Shunsuke, Fukuokaya Wataru, Honma Koichi, Huang Tingwen, Abe Hirokazu
Departments of Urology Kameda Medical Center Kamogawa Chiba Japan.
Department of Diagnostic Pathology Kameda Medical Center Kamogawa Chiba Japan.
IJU Case Rep. 2021 Jan 21;4(2):104-107. doi: 10.1002/iju5.12254. eCollection 2021 Mar.
The effect of synthetic mesh after pelvic organ prolapse surgery on the progression of bladder cancer remains unclear.
A 79-year-old woman who underwent a tension-free vaginal mesh procedure 8 years prior was diagnosed with carcinoma of the bladder. Although intravesical Bacillus Calmette-Guérin therapy was started, the tumor rapidly became muscle invasive. Laparoscopic radical cystectomy was performed following radiochemotherapy; however, the tumor extended to the left internal obturator muscle along the mesh arm. Pathological findings showed desmoplastic high-grade urothelial carcinoma infiltrating around the mesh. Finally, cancer recurred rapidly in the left internal obturator muscle.
Synthetic mesh can become an abnormal anatomical pathway for tumor infiltration. Therefore, in high-risk bladder cancer patients who underwent a tension-free vaginal mesh procedure, radical cystectomy should be performed without delay before the tumor invades the perivesical tissue.
盆腔器官脱垂手术后使用合成网片对膀胱癌进展的影响尚不清楚。
一名79岁女性,8年前接受了无张力阴道网片手术,被诊断为膀胱癌。尽管开始了膀胱内卡介苗治疗,但肿瘤迅速发展为肌层浸润性癌。放化疗后进行了腹腔镜根治性膀胱切除术;然而,肿瘤沿着网片臂扩展至左闭孔内肌。病理结果显示,促结缔组织增生性高级别尿路上皮癌在网片周围浸润。最后,癌症在左闭孔内肌迅速复发。
合成网片可成为肿瘤浸润的异常解剖途径。因此,对于接受无张力阴道网片手术的高危膀胱癌患者,应在肿瘤侵犯膀胱周围组织之前及时进行根治性膀胱切除术。