根治的膀胱全摘出後に単独皮下転移をきたした膀胱移行上皮癌の1例

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65歳男.血尿で受診し,膀胱癌の診断で,術前補助療法と動注化学放射線併用療法を施行され,膀胱尿道全摘出術,回腸導管造設術を施行された.術後,右下腹部に腫瘤を触知したため入院した.超音波で,右下腹部に内部均一な腫瘤を,CTでも造影効果のある腫瘤を認めた.膀胱移行上皮癌の皮下転移を疑い,局所麻酔下に右下腹部および左背部腫瘍摘出術を施行した.肉眼所見で腫瘤は20×15mm,8gで,赤色,弾性硬であった.病理組織検査下腹部,背部ともに,移行上皮癌(TCC)で膀胱TCCの皮下転移と診断したA case of transitional cell carcinoma (TCC) of the bladder metastasizing subcutaneously to the right lower abdomen and to the left back approximately 2 years after radical cystouretherectomy is reported. A 65-year-old male underwent radical cystouretherectomy with the creation of ileal couduit after preoperative intraarterial chemotherapy and radiotherapy. At the out patient clinic two years postoperatively, a subcutaneous tumor was palpated in the right lower abdomen and the left back. The tumors were removed and histopathologically diagnosed as subcutaneous metastases of TCC. The patient received three courses of postoperative systemic chemotherapy. At 15 months after the last chemotherapy, the patient remains free of metastases and relapse.