膀胱の癌肉腫(結合腫瘍)の1例

概要

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A 61-year-old man was seen on September, 9, 1975 with the chief complaint of intermittent gross hematuria of 4 years, duration and burning on urination for the past 2 months. Cystoscopy disclosed a large sessile tumor involving the left lateral wall of the bladder. A total cystectomy with ileal loop urinary diversion was performed on October 23, 1975. The surgical specimen demonstrated the co-existence of a solid, necrotic tumor 7×6×5 cm. in size and a papillary tumor 3×4×2 cm. in size. On microscopic examination the former was identified as myxomatous leiomyosarcoma, the latter as transitional cell carcinoma grade 3. The two components collided in some areas and invaded each other. Consequently the pathological diagnosis was carcinosarcoma (collision tumor) of the urinary bladder. Two months after the operation, urethral bleeding reappeared and an induration in the pendulous urethra was noted. As biopsy revealed sarcomatous elements, the penis was amputated and the urethra was removed. On May 13, 1976, he died with the local recurrent lesion and pulmonary metastasis, showing no response to telecobalt irradiation and chemotherapy. No autopsy was done. The literature was reviewed and the clinicopathology of the carcinosarcoma of the bladder was discussed.