G-CSF産生膀胱癌の1例

概要

論文の詳細を見る
76歳男.排尿時痛,肉眼的血尿が出現し,腹部超音波で膀胱後壁より突出する隆起性病変を指摘された.静脈性腎盂造影では上部尿路に異常を認めず,膀胱内に鵞卵大の陰影欠損を認めた.腹部CTで膀胱後壁より内腔に突出し均一に造影される径5cmの腫瘤を認め,MRI所見では壁外まで浸潤していた.白血球増多を認めたため血中G-CSF値を測定したところ,98pg/mlと高値であった.膀胱生検でTCC,G2,pT1b以上の所見が得られ,膀胱全摘術及び回腸導管造設術を施行した.術後2日で白血球数は低下し,G-CSF値も13pg/mlと正常化した.術後28日に退院し,2年経過して再発はないA case of bladder cancer producing granulocyte colony-stimulating factor (G-CSF) is reported. A 76-year-old male was admitted to our hospital with gross hematuria and leukocytosis. He was diagnosed with advanced bladder cancer. His white blood cell (WBC) count and serum granulocyte colony-stimulating factor (G-CSF) level were elevated (peak WBC 22,010/microliter, peak G-CSF 351 pg/ml), which immediately normalized after cystectomy. The histopathological diagnosis was transitional cell carcinoma, grade 3, pT4, pN1. Immunohistochemical examination was positive for G-CSF and G-CSF receptor. There has been no recurrence of cancer for more than 23 months since the operation without any additional therapy.