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膀胱上皮样恶性外周神经鞘瘤合并尿路上皮癌:一例报告

Epithelioid malignant peripheral nerve sheath tumor of the bladder and concomitant urothelial carcinoma: A case report.

作者信息

Ozden Sami Berk, Simsekoglu Muhammed Fatih, Sertbudak Ipek, Demirdag Cetin, Gurses Iclal

机构信息

Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine Department of Urology, Istanbul 34100, Fatih, Turkey.

Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine Department of Pathology, Istanbul 34100, Fatih, Turkey.

出版信息

World J Clin Cases. 2024 Jan 26;12(3):551-559. doi: 10.12998/wjcc.v12.i3.551.

Abstract

BACKGROUND

Epithelioid malignant peripheral nerve sheath tumor (EMPNST) of the bladder is a rare entity with devastating features. These tumors are thought to originate from malignant transformation of pre-existing schwannomas of pelvic autonomic nerve plexuses, and unlike the conventional malignant peripheral nerve sheath tumor (MPNST), are not associated with neurofibromatosis. The tumor has distinctive morphological, immunohistochemical and molecular features. Additionally, it tends to be more aggressive and have a higher mortality. This is the first case that presents with a synchronous urothelial carcinoma of the bladder and the epithelioid variant of MPNST in the literature. It's also the second reported case of EMPNST originating from the bladder wall.

CASE SUMMARY

In this case report, we present the detailed clinical course of a 71-year-old patient with EMPNST of the bladder alongside a literature review.

CONCLUSION

During the management of EMPNST cases, offering aggressive treatment modalities to the patient, such as radical cystectomy, is appropriate for the best chance to contain the disease, regardless of the tumor stage and the extent of local disease at initial diagnosis.

摘要

背景

膀胱上皮样恶性外周神经鞘瘤(EMPNST)是一种罕见的具有破坏性特征的实体瘤。这些肿瘤被认为起源于盆腔自主神经丛中预先存在的神经鞘瘤的恶性转化,并且与传统的恶性外周神经鞘瘤(MPNST)不同,不伴有神经纤维瘤病。该肿瘤具有独特的形态学、免疫组织化学和分子特征。此外,它往往更具侵袭性且死亡率更高。这是文献中首例同时出现膀胱尿路上皮癌和MPNST上皮样变体的病例。这也是第二例报道的起源于膀胱壁的EMPNST病例。

病例总结

在本病例报告中,我们介绍了一名71岁膀胱EMPNST患者的详细临床病程,并进行了文献综述。

结论

在处理EMPNST病例时,无论肿瘤分期和初始诊断时局部疾病的范围如何,为患者提供积极的治疗方式,如根治性膀胱切除术,对于控制疾病的最佳机会是合适的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f5d7/10841956/be968ef38876/WJCC-12-551-g001.jpg

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