著者

伊藤 伸一郎 横溝 智 今津 哲央 菅尾 英木

出版者

泌尿器科紀要刊行会

雑誌

泌尿器科紀要 (ISSN:00181994)

巻号頁・発行日

vol.51, no.11, pp.755-757, 2005-11

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72歳男.表在性膀胱癌へTUR-BtとBCG膀胱内注入を施行してから5年以上再発が見られず,治癒したと思い来院をしていなかったが,血尿及び右側腹部痛が出現した.膀胱鏡で右尿管口を覆う乳頭状広基性腫瘍を指摘され,MRIでは壁外浸潤も見られた.TUR-Bt及び動注化学療法と放射線治療を施行し,腫瘍の完全消失を認めたが,約5年後に再発を認めた.追加治療の動注化学療法は効果が見られず,膀胱全摘術を施行した.術後,再発及び転移徴候は見られなかったが,熱中症による脱水で衰弱し死亡したA 72-year-old man had undergone trasucethral resection of bladder tumor (TUR-Bt) three times from 1990 to 1991 and he had been lost to follow with no recurrence from 1996, came to our hospital complaining of asymptomatic macrohematuria in May 1999. A bladder tumor existed around the right ureteral orifice with right hydronephrosis. MRI and TUR-Bt revealed that the cancer was transitional cell carcinoma (TCC) > small cell carcinoma, G3, pT3b. Because the patient insisted on bladder preservation, intra arterial chemotherapy with cisplatinum (CDDP) and epirubicin (EPI-adr) followed by radiotherapy with CDDP was performed. The treatment resulted in a clinical complete response (CR), and the bladder was preserved. In January 2004, an invasive bladder cancer recurred at the left lateral wall. This time, neoadjuvant intra-arterial chemotherapy with CDDP and EPI-adr, followed by radical cystectomy was performed. Histologically, the recurrent bladder cancer was TCC, G3, pT3b.