摘要
目的探讨膀胱肉瘤样癌及膀胱癌肉瘤组织学特性。提高对膀胱肉瘤样癌和膀胱癌肉瘤的病理学和临床特征的认识。方法报告1例膀胱肉瘤样癌和1例膀胱癌肉瘤的病例资料。2例均为男性。年龄分别为60岁、66岁。1例以肉眼血尿就诊，膀胱镜、CT和B超检查均诊断为膀胱肿瘤，肿瘤呈侵润性生长，术前活检提示为移行上皮细胞癌。行膀胱部分切除术，术后行全身化疗和膀胱灌注化疗；病理检查为癌肉瘤。另1例以膀胱血块填塞就诊，急诊手术行血块清除、止血及肿瘤姑息性切除，术后均行全身化疗和膀胱灌注化疗，术后病理检查为肉瘤样癌。结果1例行膀胱部分切除者，术后病理可见上皮和肉瘤样间质2种恶性成分，且可见到横纹肌肉瘤成分，诊断为膀胱癌肉瘤，3个月后复查局部肿瘤复发。行膀胱全切-回肠新膀胱术，目前仍在随访中。另1例术后病理可见上皮和肉瘤样间质2种恶性成分，癌与肉瘤样区有移行，诊断为膀胱肉瘤样癌，1个月后死于全身衰竭、多处转移。结论膀胱肉瘤样癌和癌肉瘤具有浸润性生长的生物学特性，恶性程度高，预后不良；化疗、放疗都不太敏感，手术仍是首选治疗方式。
Objectives To investigate the histological essence of the sarcomatoid carcinoma and of the urinary bladder, and to improve the recognition of the pathological differences between them and their clinical characteristies. Methods The data of 1 case of bladder and 1 case of bladder sarcomatoid carsinoma were reviewed. One presented with gross hematuria. Cystoscopy, CT and B ultrasound showed bladder tumor growing invasively. Preoperative biopsies indicated transitional cell carcinoma and partial cystectomy had been done. Histopathologic diagnosis was sarcomatoid carcinoma of the urinary bladder. Postoperatively, chemotherapy through the veins and by bladder instillation was performed. The other＇s bladder was full of gore. Emergent treatments of clearing gore, hemostasis and excising tumor partially were done. Histopethology showed the tumors with epthelial, sarcomatoid mesenchyma and the ultimate diagnosis was carcinesareoma of the urinary bladder. Postoperatively, chemotherapy through the veins and by bladder instillation was performed. Results One case had been underwent partial cystectomy and histopathology showed the tumors with epithelial and sarcomatoid mesenchyma, a few rhabdomyesareama components, and the ultimate diagnosis was of the bladder. However, the tumor recurred in urinary bladder 3 months later and total cystectomy and ileum neobladder had been done. Now he was being followed up. The other＇s histopathology showed the tumors with epithelial and sarcomatoid mesenchymal components, and the ultimate diagnosis was sareomatoid carcinoma of the urinary bladder. He died of multi - metastasis, exhaustion within 1 months. Conclusions Sarcomatoid carcinoma and of the urinary bladder have the biological behavior of invasive growth. They are most often in an advanced stage at presentation, leading to an unfavorable prognosis. Their sarcomatoid cancerous essence mostly decides the bad sensitivity to the chemotherapy and radiotherapy, and the operation is still the first choice of treatment.
出处
《国际泌尿系统杂志》
2007年第2期161-164,共4页
International Journal of Urology and Nephrology
关键词
膀胱肿瘤
癌肉瘤
Bladder neoplasms
Careinosarcoma
