1例伴滋养层分化的尿路上皮癌肾转移患者经机器人辅助部分肾切除术成功治疗

A Case of Renal Metastasis of Urothelial Carcinoma With Trophoblastic Differentiation Successfully Treated With Robot-Assisted Partial Nephrectomy.

作者信息

Honda Seiichiro, Uemura Koichi, Ito Hiroki, Muraoka Erika, Tatenuma Tomoyuki, Ito Yusuke, Muraoka Kentaro, Hasumi Hisashi, Kawano Naomi, Yamanaka Shoji, Makiyama Kazuhide

机构信息

Department of Urology Yokohama City University Graduate School of Medicine Yokohama Japan.

Department of Pathology Yokohama City University Hospital Yokohama Japan.

出版信息

IJU Case Rep. 2025 Jul 13;8(5):480-484. doi: 10.1002/iju5.70072. eCollection 2025 Sep.

DOI:10.1002/iju5.70072

PMID:40909319

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12408180/

Abstract

INTRODUCTION

There are no previous reports of solitary renal metastases from urothelial carcinoma with trophoblastic differentiation, a rare bladder cancer subtype that is pathologically hCGβ positive.

CASE PRESENTATION

A 77-year-old male with urothelial carcinoma with trophoblastic differentiation underwent robot-assisted radical cystectomy following neoadjuvant chemotherapy. Pathological examination revealed urothelial carcinoma, classified as ypT2b and ypN0 with detection of focal hCGβ positivity. Postoperatively, serum hCGβ levels decreased from 1.6 to < 0.2 mIU/mL. At the 9-month follow-up, serum hCGβ was elevated to 20.1 mIU/mL with no recurrence on PET-CT. Gemcitabine-cisplatin chemotherapy was initiated; however, a solitary renal tumor was detected. Partial nephrectomy confirmed that the tumor was a renal metastasis of bladder cancer. Serum hCGβ levels decreased and remained < 0.2 mIU/mL, even 20 months after partial nephrectomy.

CONCLUSION

We report a case of urothelial carcinoma with trophoblastic differentiation and elevated serum hCGβ levels, in which a solitary renal metastasis was successfully resected by robot-assisted partial nephrectomy.

摘要

引言

此前尚无关于具有滋养层分化的尿路上皮癌孤立性肾转移的报道，这是一种罕见的膀胱癌亚型，病理检查时人绒毛膜促性腺激素β（hCGβ）呈阳性。

病例报告

一名患有具有滋养层分化的尿路上皮癌的77岁男性，在接受新辅助化疗后接受了机器人辅助根治性膀胱切除术。病理检查显示为尿路上皮癌，分类为ypT2b和ypN0，检测到局灶性hCGβ阳性。术后，血清hCGβ水平从1.6降至<0.2 mIU/mL。在9个月的随访中，血清hCGβ升高至20.1 mIU/mL，PET-CT检查未发现复发。开始使用吉西他滨-顺铂化疗；然而，检测到一个孤立性肾肿瘤。部分肾切除术证实该肿瘤为膀胱癌的肾转移。即使在部分肾切除术后20个月，血清hCGβ水平仍下降并保持<0.2 mIU/mL。