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 urinary bladder(Report of 4 cases)

Objective:To evaluate the clinical and pathological characteristics and treatments of bladder carcinosarcoma.Methods:4 cases were reported of bladder carcinosarcoma from the secondary hospitals of Tianjin medical university from 1995 to 2010,combining the literature on the diagnosis,pathological characteristics,treatment.Results:4 patients,2 males and 2 females.Age of 63 to 80 years,complained intermittent painless gross hematuria full admission.Cystoscopy prompted cauliflower mass were invasive growth.2 cases partial cystectomy,2 patients had bilateral ureteral bladder full Shaver and skin fistulization.Seen in these patients was basically the same as bladder cancer.Pathology are composed of two components of carcinoma and sarcoma,immunohistochemistry had its specific performance.Different chemotherapy were given after operations.10 months later 2 patients died due to systemic metastasis,and 2 patients were followed up for 10 months and 6 months,whom were still alive and need further observation.Conclusions:Carcinosarcoma of the urinary bladder is a rare sarcomaof bladder.There is no characteristic clinical manifestations.And diagnosis mainly depends on the pathological and immunohistochemical examination,treatment by radical cystectomy better,but its high degree of malignancy and poor prognosis,diagnosis and treatment need further observation.