若年性浸潤性膀胱小細胞癌の1例

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29歳女.肉眼的血尿を主訴に近医受診し,膀胱腫瘍を指摘され紹介受診した.膀胱鏡検査で膀胱右側壁に約15mm大の非乳頭状・広基性腫瘍を認め,生検の結果TCC,G2であった.CTとMRIでは壁外浸潤が疑われた.移行上皮癌の診断で膀胱全摘術および回腸新膀胱造設術,子宮合併切除術を施行した.摘出標本の病理所見から小細胞癌と診断し,壁外浸潤は認めなかった.術後化学療法としてIP療法(イリノテカン+シスプラチン)を4コース施行し,術後1年の現在まで再発は認めていないA 29-year-old woman with gross hematuria was referred to our hospital. Cystoscopy revealed a nonpapillary broad-based tumor on the right lateral wall of the urinary bladder, which a transurethral biopsy identified as transitional cell carcinoma (G2). CT and MRI suggested that the carcinoma invaded beyond the bladder wall. We performed a radical cystectomy with hysterectomy and the construction of an ileal neobladder. Pathological examination of the specimen indicated that it was small-cell undifferentiated carcinoma at the stage of pT2bpN0. For adjuvant chemotherapy, four cycles of CPT-11 and CDDP chemotherapy were performed, which is currently the usual chemotherapy for small-cell lung carcinoma in Japan. The patient is alive without any evidence of tumor recurrence at 12 months after surgery.
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