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一名因脊柱裂导致神经源性膀胱功能障碍的HIV阳性男性的侵袭性膀胱尿路上皮癌:一例尸检病例

Aggressive Bladder Urothelial Carcinoma in an HIV-Positive Male With Neurogenic Bladder Dysfunction due to Spina Bifida: An Autopsy Case.

作者信息

Ueno Masahiro, Sawada Norifumi, Yano Fumiakira, Shinkai Koki, Sato Yuta, Shimura Hiroshi, Kondo Tetsuo, Mochizuki Takanori, Kira Satoru, Mitsui Takahiko

机构信息

Department of Urology Interdisciplinary Graduate School of Medicine, University of Yamanashi Chuo City Yamanashi Japan.

Department of Pathology Interdisciplinary Graduate School of Medicine, University of Yamanashi Chuo City Yamanashi Japan.

出版信息

IJU Case Rep. 2025 Mar 25;8(3):261-265. doi: 10.1002/iju5.70020. eCollection 2025 May.

Abstract

INTRODUCTION

Patients with neurogenic bladder secondary to spinal cord injury are at increased risk of developing bladder urothelial carcinoma due to urinary tract infections. The contribution of HIV infection is unknown in this group of patients.

CASE PRESENTATION

A spina bifida male patient with macrohematuria and recurrent urinary tract infection was detected with bladder carcinoma covered with soft tissue thickening and was clinically diagnosed cT3N2M1. He was also diagnosed with HIV infection. Despite the treatment with Gemcitabine and Cisplatin, he developed infective endocarditis and a cerebral infarction. He died 3 months after the initiation of chemotherapy.

CONCLUSIONS

This case highlights a rare case of aggressive bladder carcinoma developed in an HIV-positive male with spina bifida, who had never used an indwelling catheter or intermittent catheterization. HIV-positive men tend to have a higher incidence of bladder cancer at a younger age, and neurogenic bladder might accelerate the progression in this case.

摘要

引言

脊髓损伤继发神经源性膀胱的患者因尿路感染而患膀胱尿路上皮癌的风险增加。在这组患者中,HIV感染的影响尚不清楚。

病例介绍

一名患有脊柱裂的男性患者出现肉眼血尿和反复尿路感染,检测发现膀胱肿瘤伴有软组织增厚,临床诊断为cT3N2M1期。他还被诊断出感染了HIV。尽管接受了吉西他滨和顺铂治疗,但他仍发生了感染性心内膜炎和脑梗死。化疗开始3个月后死亡。

结论

该病例突出了一名患有脊柱裂的HIV阳性男性发生侵袭性膀胱癌的罕见病例,该患者从未使用过留置导管或间歇性导尿。HIV阳性男性在较年轻时患膀胱癌的发病率往往较高,在本病例中神经源性膀胱可能加速了疾病进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec7c/12055217/b4171a7208f5/IJU5-8-261-g002.jpg

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