動注療法により腹腔内穿孔をきたした膀胱扁平上皮癌の1例

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We report a case of invasive squamous cell carcinoma of the urinary bladder, which was perforated intraperitoneally after intra-arterial chemotherapy. The patient was a 67-year-old woman complaining of macrohematuria and body weight loss. After thorough examination, the diagnosis of clinical stage C of squamous cell carcinoma of urinary bladder was made. At first, balloon occluded intra-arterial infusion with 80 mg, cis-dichlorodiamine platinum 10 mg mitomycin C and 1 mg vincristine was performed, followed by radiotherapy and 15 mg bleomycin injection. On the 5th day, the patient fell into shock with abdominal expansion, and bladder perforation into peritoneal cavity was confirmed by rapid cystography. Emergency cystohysterectomy and drainage were performed. Resected bladder had a large defect on its posterior wall, and tumor had fallen into severe necrosis. Since January, 1986 we performed balloon occluded intra-arterial infusion of antineoplastic drugs for 3 other cases. We obtained a partial response for 2 of these cases. The outcome of intra-arterial chemotherapy in our hospital is also reported.