内容紹介
Summary
A 66-year-old man had bilateral lower limb paralysis 30 years ago owing to traumatic injury of the thoracic spinal cord, and surgery(cystostomy)was performed 23 years ago. He was transferred to our hospital following treatment of sepsis owing to a worsening decubitus. There was a 4 cm sized mucin-producing tumor at the inserted site of cystostomy. We performed tumor resection. Histological examination revealed the tumor to be a mucin-producing well-differentiated adenocarcinoma. There was no tumor in any other organ. There was a residual tumor at the inserted site, and it was located at the dome of the bladder, which we considered to urachal cancer. Therefore, we performed partial resection of the bladder. Histological examination revealed a well-differentiated adenocarcinoma extending from the urachal epithelium, and thus, it was diagnosed as urachal cancer. This is an extremely rare disease and is the first report from Japan.
要旨
症例は66歳,男性。30年前に外傷性胸髄損傷のため両下肢麻痺となり,23年前に膀胱瘻を造設した。仙骨部褥瘡の悪化による敗血症で加療後に当院に転院となった。膀胱瘻の挿入部に粘液分泌を有する径4 cmの腫瘤があり摘出したところ,粘液産生性高分化腺癌の診断となった。他に腫瘍性病変はなく,膀胱鏡検査では瘻孔部に腫瘍の遺残を認め,膀胱頂部に局在することより尿膜管癌を疑い,膀胱部分切除術を施行した。病理組織学的に残存した尿膜管上皮細胞から連続する高分化腺癌を認め,尿膜管癌の確定診断に至った。本疾患は非常にまれであり,膀胱瘻挿入部に発生した尿膜管癌の報告は本邦初である。
目次
A 66-year-old man had bilateral lower limb paralysis 30 years ago owing to traumatic injury of the thoracic spinal cord, and surgery(cystostomy)was performed 23 years ago. He was transferred to our hospital following treatment of sepsis owing to a worsening decubitus. There was a 4 cm sized mucin-producing tumor at the inserted site of cystostomy. We performed tumor resection. Histological examination revealed the tumor to be a mucin-producing well-differentiated adenocarcinoma. There was no tumor in any other organ. There was a residual tumor at the inserted site, and it was located at the dome of the bladder, which we considered to urachal cancer. Therefore, we performed partial resection of the bladder. Histological examination revealed a well-differentiated adenocarcinoma extending from the urachal epithelium, and thus, it was diagnosed as urachal cancer. This is an extremely rare disease and is the first report from Japan.
要旨
症例は66歳,男性。30年前に外傷性胸髄損傷のため両下肢麻痺となり,23年前に膀胱瘻を造設した。仙骨部褥瘡の悪化による敗血症で加療後に当院に転院となった。膀胱瘻の挿入部に粘液分泌を有する径4 cmの腫瘤があり摘出したところ,粘液産生性高分化腺癌の診断となった。他に腫瘍性病変はなく,膀胱鏡検査では瘻孔部に腫瘍の遺残を認め,膀胱頂部に局在することより尿膜管癌を疑い,膀胱部分切除術を施行した。病理組織学的に残存した尿膜管上皮細胞から連続する高分化腺癌を認め,尿膜管癌の確定診断に至った。本疾患は非常にまれであり,膀胱瘻挿入部に発生した尿膜管癌の報告は本邦初である。