膀胱温存が可能であった局所浸潤性膀胱憩室扁平上皮癌の1例

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無症候性肉眼的血尿を主訴とした62歳男で,膀胱鏡検査で膀胱頂部に2つの憩室が見られ,中1個は腫瘍性病変で満たされていた.生検でグレード1の扁平上皮癌と判明したが,膀胱粘膜の残りの部分には悪性は認められなかった.膀胱温存療法を選択した.膀胱部分切除後の病理診断は扁平上皮癌,G1>G2,pT3bであった.術後,メトトレキサート,ブレオマイシン,及びシスプラチンによる化学療法を3クール行った.4.5年間再発なしに留まっているA 62-year-old man visited our hospital with asymptomatic gross hematuria. On cystoscopy, two diverticula were identified at the dome of the urinary bladder and one of them was packed with a tumor. Biopsy showed squamous cell carcinoma (SCC), G1, but malignancy was not detected in the rest of the vesical mucosa. We selected bladder-preserving therapy. Pathological diagnosis after partial cystectomy was SCC, G1 > G2, pT3b. Postoperatively, 3 courses of adjuvant chemotherapy with methotrexate, bleomycin and cisplatin were performed. The patient has remained free of recurrence for 4.5 years.