Ito K, Tanomogi H, Hasegawa S
Department of Urology, Tochigi National Hospital.
Hinyokika Kiyo. 1997 Dec;43(12):871-4.
A 70-year-old woman presented at our hospital with the chief complaint of gross hematuria and pain on urination. Cystoscopy revealed a broad-based tumor covered with mucus on the right wall of the bladder and therefore a transurethral resection was performed. At surgery the tumor was found to arise from the diverticulum and could not be resected because of the risk of perforation. A histopathological examination disclosed adenocarcinoma including a small region of signet ring cell carcinoma. The tumor was thus diagnosed to be adenocarcinoma originating from the vesical diverticulum and total cystectomy and urinary diversion (ileal conduit) were scheduled. At operation, the carcinoma was found to have infiltrated into the cecum. The operation procedure was therefore changed to partial cystectomy and excision of the cecum in consideration of both the patient's quality of life and her overall prognosis. Although a tumor originating from the vesical diverticulum and adenocarcinoma are both considered to be factors indicating a poor prognosis, no signs of recurrence or metastasis have been detected in this patient at 26 months after the operation.
一名70岁女性因肉眼血尿和排尿疼痛为主诉前来我院就诊。膀胱镜检查发现膀胱右壁有一个基底较宽、表面覆盖黏液的肿瘤，遂行经尿道切除术。手术中发现肿瘤起源于憩室，因有穿孔风险无法切除。组织病理学检查显示为腺癌，其中包含一小区域印戒细胞癌。因此，该肿瘤被诊断为起源于膀胱憩室的腺癌，计划行全膀胱切除术及尿流改道（回肠代膀胱术）。手术时发现癌已浸润至盲肠。考虑到患者的生活质量和总体预后，手术方式改为部分膀胱切除术及盲肠切除术。虽然起源于膀胱憩室的肿瘤和腺癌均被认为是预后不良的因素，但该患者术后26个月未检测到复发或转移迹象。
