膀胱癌肉瘤的临床特征(附2例报告)

目的:探讨膀胱癌肉瘤的临床特征。方法:报告2例膀胱癌肉瘤患者的临床资料。2例均以尿痛、间断肉眼血尿就诊。2例均行膀胱部分切除 输尿管移植术,术后3个月和8个月因肿瘤复发再次行全膀胱切除 回肠膀胱术。结果:病理检查报告为膀胱癌肉瘤。2例分别在术后82天和91天死于肝、肺广泛转移。结论:膀胱癌肉瘤罕见,易复发,转移快,预后极差。诊断依靠病理及免疫组化检查。     

膀胱癌肉瘤诊疗体会(附3例报告)

目的:探讨膀胱癌肉瘤的诊断及治疗方法。方法:回顾性分析我院2005年~2012年收治的3例膀胱癌肉瘤患者的临床资料,3例患者均以全程无痛肉眼血尿为首发症状,伴排尿困难2例,尿频、尿急1例,膀胱镜检示肿瘤发生于膀胱左侧壁2例,膀胱顶底部1例。3例患者中1例行经尿道膀胱肿瘤电切术(TURBT),1例行全膀胱切除术+回肠膀胱术,1例行膀胱全切术+双侧输尿管皮肤造口术。结果:所有患者术后病理均证实为膀胱癌肉瘤,3例均为高级别。患者术后均获随访,随访时间10~36个月,1例术后10个月死亡,1例术后2年死亡。1例术后至今存活3年。结论:膀胱癌肉瘤是一种少见的高度恶性的膀胱肿瘤,根治性膀胱切除术是主要的治疗方式,术后放化疗效果均不理想,预后差。     

膀胱癌肉瘤2例报告

目的：总结膀胱癌肉瘤的临床特征及病理特点.方法：报告2例膀胱癌肉瘤病例资料.2例均为男性,年龄分别为67、83岁.均以间歇性血尿或伴尿痛入院,影像学及膀胱镜检查诊断为膀胱肿瘤.结果：2例病理检查发现同时存在癌与肉瘤成分.1例行全膀胱切除回肠膀胱术,于术后3个月死于肿瘤全身转移.1例行膀胱部分切除术,随访16个月,无肿瘤转移及复发.仍健在.结论：膀胱癌肉瘤恶性程度高,浸润性强,易早期转移.诊断依赖病理学检查和免疫组化.早期发现及根治性切除,可能延长患者的生存期.     

膀胱癌肉瘤二例报告

目的　总结膀胱癌肉瘤的组织发生、临床及病理特点。　方法　报告 2例膀胱癌肉瘤 ,男女各 1例 ,均以间断性无痛肉眼血尿收入院 ,对其组织病理及临床经过进行分析。　结果　 2例膀胱镜均示息肉或菜花样肿物 ,呈浸润性生长 ,表面可见钙化 ,CT示膀胱壁实质性占位。 2例均行膀胱部分切除术 ,术中所见与膀胱癌基本相同。病理可见上皮和间质两种恶性成分 ,上皮部分由高分级移行细胞组成 ,上皮之间混杂有恶性间质成分 ,呈异常增殖状 ,可见有丝分裂相。术后应用溶肉瘤素治疗 ,1例术后 11个月死亡 ,另 1例术后 16个月死亡。　结论　膀胱癌肉瘤具有高度恶性和浸润性生长的生物学特性 ,预后不良。对间断无痛性肉眼血尿患者应警惕本病发生。     

2例膀胱癌肉瘤诊治分析

目的提高膀胱癌肉瘤的认识及诊治水平。方法回顾复习2例膀胱癌肉瘤的临床资料,2例术前均以无痛性肉眼血尿入院,B超及CT均提示膀胱占位,膀胱镜下见肿块向膀胱突出,有蒂,活检1例提示移行细胞癌2~3级,1例提示鳞状细胞癌,均行膀胱部分切除。结果手术后病理2例均为膀胱癌肉瘤,1例癌成分为移行细胞,另一例为鳞状细胞。1例3个月后复发行根治性膀胱切除,5个月后死于全身转移。另一例8个月后死于原位复发。结论膀胱癌肉瘤临床罕见,恶性程度极高,术前易诊治为癌而忽略肉瘤成分,愈后差。     

膀胱癌肉瘤1例报告并附文献复习

目的结合文献复习,探讨膀胱癌肉瘤的临床特征及诊治水平。方法报告1例膀胱癌肉瘤患者的临床和病理资料,以无痛性肉眼血尿伴排尿困难为主要症状,CTU提示膀胱占位,膀胱镜下见巨大膀胱内肿物,活检病理提示癌肉瘤可能性大。结果行腹腔镜下全膀胱切除加回肠膀胱术,术后病理诊断为膀胱癌肉瘤,显微镜下主要由高分化移行细胞癌和肉瘤成分组成,辅以GC方案化疗。结论诊断依赖病理及免疫组化检查,膀胱癌肉瘤具有高度恶性和浸润性生长的生物学特性,治疗主要是以行根治性手术为主,预后不良。     

膀胱肉瘤样癌与癌肉瘤

目的探讨膀胱肉瘤样癌及膀胱癌肉瘤组织学特性。提高对膀胱肉瘤样癌和膀胱癌肉瘤的病理学和临床特征的认识。方法报告1例膀胱肉瘤样癌和1例膀胱癌肉瘤的病例资料。2例均为男性。年龄分别为60岁、66岁。1例以肉眼血尿就诊，膀胱镜、CT和B超检查均诊断为膀胱肿瘤，肿瘤呈侵润性生长，术前活检提示为移行上皮细胞癌。行膀胱部分切除术，术后行全身化疗和膀胱灌注化疗；病理检查为癌肉瘤。另1例以膀胱血块填塞就诊，急诊手术行血块清除、止血及肿瘤姑息性切除，术后均行全身化疗和膀胱灌注化疗，术后病理检查为肉瘤样癌。结果1例行膀胱部分切除者，术后病理可见上皮和肉瘤样间质2种恶性成分，且可见到横纹肌肉瘤成分，诊断为膀胱癌肉瘤，3个月后复查局部肿瘤复发。行膀胱全切-回肠新膀胱术，目前仍在随访中。另1例术后病理可见上皮和肉瘤样间质2种恶性成分，癌与肉瘤样区有移行，诊断为膀胱肉瘤样癌，1个月后死于全身衰竭、多处转移。结论膀胱肉瘤样癌和癌肉瘤具有浸润性生长的生物学特性，恶性程度高，预后不良；化疗、放疗都不太敏感，手术仍是首选治疗方式。     

膀胱憩室癌肉瘤2例报告

目的:研究膀胱憩室癌肉瘤的临床及病理特点.方法:回顾性分析2例膀胱憩室癌肉瘤的病例资料,年龄分别为61和68岁,经影像学检查诊断为膀胱憩室肿瘤.1例行经尿道膀胱憩室肿物电切术,1例行膀胱部分切除术.术后病理和免疫组织化学检查证实为癌肉瘤.2例术后均未行放化疗.结果:2例分别于术后16个月和6个月死于肿瘤转移.结论:此病临床罕见,好发于老年男性.其诊断主要依靠病理检查和免疫组织化学检查.手术是治疗膀胱憩室癌肉瘤的最佳方法.     

儿童及青少年膀胱癌临床特点与发病机制研究(附1例罕见17岁女性膀胱癌报告)

目的:分析总结小儿膀胱癌临床特点,发病机制及相应的诊疗方案。方法:回顾分析1995~2016年北京大学第一医院泌尿外科收治膀胱癌患者,报告1例17岁女性膀胱癌患者的临床病理特点及诊疗过程,并探讨儿童膀胱癌的发病机制。结果:17岁膀胱癌女性患者主要临床表现为间断无痛肉眼血尿、无吸烟等常见膀胱癌相关危险因素,予以行经尿道膀胱肿瘤电切术(TURBT),术后未予行膀胱灌注化疗或免疫治疗。术后病理提示:低度恶性潜能尿路上皮乳头状肿瘤。免疫组化:Ki-671%,FGFR3-。术后24个月复查泌尿系统超声及膀胱镜未见肿瘤复发。结论:儿童及青少年膀胱癌十分少见,女性患者更为少见。其发病机制与传统成年人的发病机制截然不同。病理类型多为分化较好的低度恶性潜能尿路上皮乳头状肿瘤或低级别尿路上皮癌,肌层浸润少见。临床预后较好。治疗方案主要为TURBT,除术后病理提示高级别尿路上皮癌外,术后可不予与膀胱灌注化疗或免疫治疗。     

膀胱癌肉瘤4例临床病理分析

目的:探讨膀胱癌肉瘤的临床表现、病理特征、治疗方法等。方法:报告1995～2010年天津医科大学第二医院的4例膀胱癌肉瘤疾病的情况,并结合文献对之诊断、病理、治疗等行进一步分析。结果:4例患者中,男2例,女2例,年龄63～80岁。均因间歇性无痛全程肉眼血尿入院,膀胱镜检查均提示菜花样肿物,呈浸润性生长。2例行膀胱部分切除术,2例行膀胱全切加双侧输尿管皮肤造瘘术。术中所见与膀胱癌基本相同。术后病理检查均有癌和肉瘤两种成分,免疫组化有膀胱癌肉瘤较特异性表现。术后予以不同的化疗等。结论:膀胱癌肉瘤在膀胱恶性肿瘤中罕见,没有特征性的临床表现,确诊主要依靠病理和免疫组化检查;治疗方法采用根治性膀胱切除术较佳,但其恶性程度高,预后不良,诊断和治疗需要进一步探索。     

Carcinosarcoma of the bladder diverticulum: a case report and review of literature

A 56-year-old man with carcinosarcoma of the bladder diverticulum is reported. Histologically, the tumor contained two elements: carcinomatous and sarcomatous components with a transitional phase between them. The related literature is also reviewed.     

A case of true carcinosarcoma in bladder diverticulum]

We report a case of carcinosarcoma arising from a bladder diverticulum. A 71-year-old male was referred to our hospital for macroscopic hematuria. Two diverticula were identified in the left wall of the urinary bladder, one of which showed a broad-based tumor. The bladder tumor was resected using a transuretheral approach and the tumor was histologically diagnosed as leiomyosarcoma. The patient underwent partial resection of the bladder including the two diverticula and the tumor. Pathological examination revealed that the resected specimen was composed of three elements, transitional cell carcinoma (G3), squamous cell carcinoma, and leiomyosarcoma. Thus, the patient was diagnosed with carcinosarcoma. He died 5 months after surgery to remove the panperitonitis carcinomatosa. This case is the 38th reported case of bladder carcinosarcoma in Japan.     

Sarcomatoid carcinoma and carcinosarcoma of the urinary bladder

Two cases, sarcomatoid carcinoma and carcinosarcoma, of the urinary bladder are reported. A 68-year-old man with sarcomatoid carcinoma underwent total cystectomy and was alive and had had no recurrence after 21 months. A 78-year-old woman with carcinosarcoma underwent total cystectomy, but she died from increasing multiple lung metastases 4 months after surgery. The histopathological characteristics of both neoplasms are reported and discussed.     

Carcinosarcoma of the urinary bladder

A case of carcinosarcoma of the urinary bladder is reported. Transurethral resection was performed. Histologically the tumorous mass was composed of osteosarcoma, squamous cell carcinoma and transitional cell carcinoma. The histological findings, immunohistochemical features and clinical manifestations of bladder carcino-sarcoma are discussed in relation to the literature.     

Case of carcinosarcoma of urinary bladder obtained a pathologically complete response by neoadjuvant chemoradiotherapy

Carcinosarcoma of the bladder is an unusual malignancy characterized by an intimate admixture of malignant epithelial elements (carcinoma) and malignant soft tissue elements (sarcoma). To our knowledge, almost 80 cases have been reported, usually as case reports or small series. Patient with carcinosarcoma usually present with a high stage malignancy. Cystectomy or transurethral resection is the preferred treatment, often followed by radiation therapy, although prognosis is very bad. We herein report a case of carcinosarcoma of bladder obtained pathologically complete response by neoadjuvant chemoradiotherapy. She now shows no evidence of disease 30 months after the operation. To our knowledge, it is the first case where urinary bladder carcinosarcoma obtained a pathologically complete response by chemoradiotherapy.     

Primary heterologous carcinosarcoma of the ureter with necrotic malignant polyps. Report of a case and review of the literature

Carcinosarcoma is a rare and aggressive disease characterized by biphasic neoplasms with distinct mesenchymal and epithelial components. We report a case of ureteral carcinosarcoma with malignant necrotic polyps. The patient was a 58-year-old woman with painless hematuria, who was later diagnosed as having ureteral carcinosarcoma. Three long pendulous polypoid-shape tumors consisting of high-grade transitional cell carcinoma with chondrosarcomatous and osteosarcomatous elements were found. Two months after nephroureterectomy, the tumor relapsed in the bladder. Despite anterior exenteration, the patient died of local recurrence 6 months after her initial visit. To our knowledge, only 10 cases of this disease have been reported in the literature.     

Carcinosarcoma of the bladder diverticulum and a review of the literature

We report a carcinosarcoma within a bladder diverticulum together with a review of 18 previously reported cases of intradiverticular sarcomas and carcinosarcomas with respect to their clinical features, treatments and outcomes. Frequent deaths with intra-abdominal recurrences suggest the need for total cystectomy, rather than diverticulectomy.     

泌尿生殖系罕见癌肉瘤4例报告

目的：探讨泌尿生殖系癌肉瘤的诊断和治疗。方法：总结2例阴茎癌肉瘤、1例肾脏癌肉瘤、1例膀胱癌肉瘤患者的临床资料。4例均行手术切除。结果：术后病理和免疫组化证实为癌肉瘤，1例于术后2个月死于呼吸衰竭、1例失访、另2例现已分别生存6个月和10个月。结论：泌尿生殖系癌肉瘤临床罕见，术前诊断困难，免疫组化有助于诊断。恶性程度高，预后差，尽早行根治性切除是最佳治疗方法。