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新辅助吉西他滨-顺铂与抗结核治疗联合用于一名卡介苗膀胱内灌注治疗后进展的肌层浸润性膀胱癌合并肾肉芽肿病患者

Combination of Neoadjuvant Gemcitabine-Cisplatin and Anti-Tuberculosis Therapy for a Patient With Muscle-Invasive Bladder Cancer and Renal Granulomatosis That Progressed After Intravesical Bacillus Calmette-Guérin Therapy.

作者信息

Tsumori Takahiro, Hoshi Seiji, Yaginuma Kei, Meguro Satoru, Matsuoka Kanako, Hata Junya, Sato Yuichi, Akaihata Hidenori, Ogawa Soichiro, Kojima Yoshiyuki

机构信息

Department of Urology Fukushima Medical University School of Medicine Fukushima Japan.

出版信息

IJU Case Rep. 2025 May 28;8(4):419-422. doi: 10.1002/iju5.70057. eCollection 2025 Jul.

Abstract

INTRODUCTION

A case of muscle-invasive bladder cancer and renal granulomatosis that developed after intravesical Bacillus Calmette-Guérin therapy, in which a combination of neoadjuvant gemcitabine-cisplatin and anti-tuberculosis therapy was safely administered, and radical cystectomy was ultimately performed, is reported.

CASE PRESENTATION

A 64-year-old man with non-muscle-invasive bladder cancer underwent transurethral resection and intravesical Bacillus Calmette-Guérin therapy every time bladder cancer recurred. However, the patient developed left renal granulomatosis during treatment. Anti-tuberculosis therapy was prioritized since there was no bladder cancer progression. However, local bladder cancer progression was observed during the anti-tuberculosis therapy. To successfully cure the renal granulomatosis and suppress tumor progression, neoadjuvant gemcitabine-cisplatin was combined with anti-tuberculosis therapy for 2 months, followed by radical cystectomy. There were no gemcitabine-cisplatin complications and no renal granulomatosis recurrence during combination therapy.

CONCLUSION

Combination of gemcitabine-cisplatin and anti-tuberculosis therapy was possible for a patient with bladder cancer when Bacillus Calmette-Guérin infection was under control.

摘要

引言

报告了一例卡介苗膀胱内灌注治疗后发生肌肉浸润性膀胱癌和肾肉芽肿病的病例,该患者安全接受了吉西他滨-顺铂新辅助化疗与抗结核治疗联合方案,并最终接受了根治性膀胱切除术。

病例介绍

一名64岁非肌肉浸润性膀胱癌男性患者每次膀胱癌复发时均接受经尿道切除术和卡介苗膀胱内灌注治疗。然而,患者在治疗期间发生了左肾肉芽肿病。由于当时无膀胱癌进展,故优先进行抗结核治疗。然而,在抗结核治疗期间观察到局部膀胱癌进展。为成功治愈肾肉芽肿病并抑制肿瘤进展,吉西他滨-顺铂新辅助化疗与抗结核治疗联合应用2个月,随后进行根治性膀胱切除术。联合治疗期间未出现吉西他滨-顺铂相关并发症,肾肉芽肿病也未复发。

结论

当卡介苗感染得到控制时,膀胱癌患者可接受吉西他滨-顺铂与抗结核治疗联合方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cefd/12212942/387473b3fd65/IJU5-8-419-g004.jpg

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