Miñana López B, Fernández Aparicio T, Carrero López V, Caballero Alcántara J, García Luzón A, Pamplona Casamayor M, Leiva Galvis O
Servicio de Urología, Hospital Universitario 12 de Octubre, Madrid.
Actas Urol Esp. 1993 Sep;17(8):523-8.
Retrospective study conducted on 58 patients with vesical diverticulum seen in our unit between 1975 and 1992, of which a total of 11 (18.9%) patients had vesical tumours. Of these, 6 (10.3%) were intradiverticular and 5 (8.6%) extradiverticular. Sixty-six percent of patients with intradiverticular tumours also had prior or concurrent history of extradiverticular vesical tumours. The most frequent clinical presentation was gross haematuria. The abdomino-pelvic CT is the most sensitive morphological examination although in 33% cases it resulted in overstaging. Curative treatment was only possible in the 4 patients with urothelial tumours, in whom 3 partial cystectomies with pelvian lymphadenectomy (2 pT1 G2 and 1 pT3 G3) and 1 TUR (T1 G2) were performed. The 2 (33%) remaining patients had advanced locoregional epidermoid carcinoma (T4 N+). All patients with urothelial carcinoma are alive with follow-up ranging between 6 months for the one infiltrant case and 136 months for a surface tumour undergoing partial cystectomy. Prognosis for both epidermoid carcinoma was ominous with mean survival time of 9 months. Review of the literature and discussion of epidemiological, clinical, diagnostic, therapeutic and prognostic issues.
对1975年至1992年间在我院就诊的58例膀胱憩室患者进行回顾性研究，其中共有11例（18.9%）患者患有膀胱肿瘤。其中，6例（10.3%）为憩室内肿瘤，5例（8.6%）为憩室外肿瘤。憩室内肿瘤患者中有66%也有憩室外膀胱肿瘤的既往史或并存史。最常见的临床表现是肉眼血尿。腹盆腔CT是最敏感的形态学检查，尽管在33%的病例中导致分期过高。仅4例尿路上皮肿瘤患者可行根治性治疗，其中3例行部分膀胱切除术加盆腔淋巴结清扫术（2例pT1 G2和1例pT3 G3），1例行经尿道膀胱肿瘤切除术（T1 G2）。其余2例（33%）患者患有局部晚期表皮样癌（T4 N+）。所有尿路上皮癌患者均存活，随访时间为1例浸润性病例6个月至1例接受部分膀胱切除术的表浅肿瘤136个月。两种表皮样癌的预后均不佳，平均生存时间为9个月。对文献进行综述并讨论流行病学、临床、诊断、治疗和预后问题。
