1例膀胱尿路上皮癌伴鳞状分化，侵犯小肠和腹直肌，采用短股薄肌肌皮瓣治疗
A Case of Urothelial Carcinoma With Squamous Differentiation of the Bladder, Infiltrating the Small Intestine and Rectus Abdominis, Treated With the Use of a Short Gracilis Myocutaneous Flap.
作者信息
Imai Kazuto, Masuda Norihiko, Hazama Tatsuya, Nagahama Kanji, Ito Takashi, Matsushita Takakazu, Muneta Yoko, Inoue Tadashi, Akao Toshiya
机构信息
The Department of Urology Rakuwakai Otowa Hospital Kyoto Japan.
The Department of Surgery Rakuwakai Otowa Hospital Kyoto Japan.
出版信息
IJU Case Rep. 2025 Jul 21;8(5):494-497. doi: 10.1002/iju5.70077. eCollection 2025 Sep.
INTRODUCTION
Squamous differentiation (SD) occurs in up to 20% of muscle invasive bladder cancers.
CASE PRESENTATION
An 85-year-old man with an intrapelvic mass invading the bladder, small intestine, and rectus abdominis presented to our department. Cystoscopy showed a necrotic mass at the dome of the bladder. Histopathological examination of specimens from transurethral resection indicated squamous cell carcinoma. Radical cystectomy with resection of the small intestine and rectus abdominis, and reconstruction of the abdominal wall using a left short gracilis myocutaneous flap was performed. The histopathology showed squamous cell carcinoma and urothelial carcinoma (UC) components; findings consisted of UC with SD. The patient received appropriate flap management and treatment for postoperative complications and was discharged on postoperative Day 100.
CONCLUSION
To our knowledge, this is the first report of an invasive bladder cancer with SD treated with the use of a short gracilis myocutaneous flap.
引言
高达20%的肌层浸润性膀胱癌会发生鳞状分化（SD）。
病例介绍
一名85岁男性因盆腔内肿物侵犯膀胱、小肠和腹直肌就诊于我院。膀胱镜检查显示膀胱顶部有一坏死肿物。经尿道切除术标本的组织病理学检查提示为鳞状细胞癌。遂行根治性膀胱切除术，切除小肠和腹直肌，并采用左侧短股薄肌肌皮瓣重建腹壁。组织病理学显示为鳞状细胞癌和尿路上皮癌（UC）成分；结果为伴有SD的UC。患者接受了适当的皮瓣处理及术后并发症治疗，术后第100天出院。
结论
据我们所知，这是首例使用短股薄肌肌皮瓣治疗伴有SD的浸润性膀胱癌的报告。
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