Mo Li-Cai, Piao Song-Zhe, Zheng Hai-Hong, Hong Tao, Feng Qin, Ke Mang
Department of Urology, Taizhou Hospital of Zhejiang Province Affiliated with Wenzhou Medical University, Taizhou 317000, Zhejiang Province, China.
Department of Pathology, Taizhou Hospital of Zhejiang Province Affiliated with Wenzhou Medical University, Taizhou 317000, Zhejiang Province, China.
World J Clin Cases. 2021 Jun 16;9(17):4373-4380. doi: 10.12998/wjcc.v9.i17.4373.
Pelvic lipomatosis (PL) is a rare benign condition with characteristic overgrowth of histologically benign fat and invasion and compression of pelvic organs, often leading to non-specific lower urinary tract symptoms (LUTS). Approximately 40% of patients with PL have cystitis glandularis (CG). The cause of PL combined with CG is poorly understood, and there is currently no effective treatment. Refractory CG with upper urinary tract obstruction even requires partial or radical bladder resection.
In this case, a patient suffering from PL with CG was treated by transurethral resection of bladder tumour (TUR-BT) and oral administration of celecoxib, a selective cyclooxygenase-2 (COX-2) inhibitor. The LUTS were alleviated, and the cystoscopy results improved significantly. Immunohistochemistry showed up-regulated COX-2 expression in the epithelium of TUR-BT samples, suggesting that COX-2 may participate in the pathophysiological process of PL combined with CG.
We report for the first time that celecoxib may be an effective treatment strategy for PL combined with refractory CG.
盆腔脂肪增多症(PL)是一种罕见的良性疾病,其特征是组织学上良性脂肪过度生长,并侵袭和压迫盆腔器官,常导致非特异性下尿路症状(LUTS)。约40%的PL患者合并腺性膀胱炎(CG)。PL合并CG的病因尚不清楚,目前尚无有效治疗方法。难治性CG伴上尿路梗阻甚至需要行部分或根治性膀胱切除术。
在本病例中,一名患有PL合并CG的患者接受了经尿道膀胱肿瘤切除术(TUR-BT)及口服选择性环氧化酶-2(COX-2)抑制剂塞来昔布治疗。LUTS得到缓解,膀胱镜检查结果显著改善。免疫组化显示TUR-BT样本上皮中COX-2表达上调,提示COX-2可能参与了PL合并CG的病理生理过程。
我们首次报道塞来昔布可能是治疗PL合并难治性CG的有效策略。