内容紹介
Summary
A 61-year-old man was referred to the urology department in our hospital with gross hematuria and hydro nephrosis. Cystoscopy revealed a smooth mass lesion in his bladder, and a transurethral biopsy was performed. Signet ring cell carcinoma was found in the submucosa. Upper gastrointestinal endoscopy revealed an ulcerated lesion in his gastric body. Biopsy specimens obtained from the ulcerated lesion showed signet ring cell carcinoma. No other primary lesions were detected using colonoscopy, gallium scintigraphy, or computed tomography of the chest. He was ultimately diagnosed with advanced gastric cancer with bladder metastasis. He was prescribed combination chemotherapy of cisplatin and tegafur, gimeracil, oteracil potassium, and trastuzumab. After 2 courses of chemotherapy, there was a decrease in the size of both the gastric and bladder lesions. There was also a significant decrease in the tumor marker levels. He is currently alive after 7 courses of chemotherapy.
要旨
症例は61歳,男性。血尿,水腎症にて当院泌尿器科へ紹介となった。膀胱鏡を施行し,膀胱粘膜に平滑な腫瘤を認めた。生検病理にて,粘膜下層に印環細胞癌が検出された。上部消化管内視鏡検査で胃体部に潰瘍性病変を認め,生検病理で印環細胞癌が検出された。他臓器に原発巣を認めず,最終的に胃印環細胞癌の膀胱転移と診断した。テガフール・ギメラシル・オテラシルカリウム,シスプラチン,トラスツズマブ併用化学療法を2コース施行後,胃,膀胱病変は縮小した。7コースが終了した現在,生存が得られている。
目次
A 61-year-old man was referred to the urology department in our hospital with gross hematuria and hydro nephrosis. Cystoscopy revealed a smooth mass lesion in his bladder, and a transurethral biopsy was performed. Signet ring cell carcinoma was found in the submucosa. Upper gastrointestinal endoscopy revealed an ulcerated lesion in his gastric body. Biopsy specimens obtained from the ulcerated lesion showed signet ring cell carcinoma. No other primary lesions were detected using colonoscopy, gallium scintigraphy, or computed tomography of the chest. He was ultimately diagnosed with advanced gastric cancer with bladder metastasis. He was prescribed combination chemotherapy of cisplatin and tegafur, gimeracil, oteracil potassium, and trastuzumab. After 2 courses of chemotherapy, there was a decrease in the size of both the gastric and bladder lesions. There was also a significant decrease in the tumor marker levels. He is currently alive after 7 courses of chemotherapy.
要旨
症例は61歳,男性。血尿,水腎症にて当院泌尿器科へ紹介となった。膀胱鏡を施行し,膀胱粘膜に平滑な腫瘤を認めた。生検病理にて,粘膜下層に印環細胞癌が検出された。上部消化管内視鏡検査で胃体部に潰瘍性病変を認め,生検病理で印環細胞癌が検出された。他臓器に原発巣を認めず,最終的に胃印環細胞癌の膀胱転移と診断した。テガフール・ギメラシル・オテラシルカリウム,シスプラチン,トラスツズマブ併用化学療法を2コース施行後,胃,膀胱病変は縮小した。7コースが終了した現在,生存が得られている。