膀胱炎性肌纤维母细胞瘤一例报告并文献复习

目的探讨膀胱炎性肌纤维母细胞瘤的临床、病理、组织化学特性和诊治方法及预后。方法总结1例膀胱炎性肌纤维母细胞瘤患者的临床资料。患者,男,54岁,肉眼血尿10 d入院。盆腔B超及CT增强扫描示膀胱前壁占位性病变。膀胱镜检可见顶壁4 cm×4 cm×5 cm肿物,表面缺血呈暗红色,病理活检疑为膀胱尿路上皮恶性肿瘤。结果行膀胱部分切除术。组织学表现为增生的梭形或长梭形肿瘤细胞囊状分布,间质小血管增生,伴淋巴细胞、嗜酸性粒细胞及浆细胞浸润,诊断为膀胱炎性肌纤维母细胞瘤。免疫组织化学染色结果为瘤细胞平滑肌特异性肌动蛋白（＋）、波形蛋白（＋）、间变性淋巴瘤激酶（＋）。随访6个月,患者无瘤存活。结论膀胱炎性肌纤维母细胞瘤确诊依据病理学检查,应与横纹肌肉瘤、梭形细胞肉瘤等鉴别,治疗以膀胱部分切除或经尿道切除为主。     

Leukoplakia of the bladder: a case report and literature review

An 81-year-old woman presented with symptoms of recurrent urinary tract infections, urge incontinence and nocturia. Cystoscopy performed revealed a whitish plaque lesion on the fundus and right lateral wall of the bladder. The histology of the biopsy confirmed the diagnosis of leukoplakia vesicae of the bladder. The plan is to follow her up with repeat cystoscopy and biopsy in 6 months. The literature search revealed very little information on the pathogenesis and prognosis of this condition due to its rare occurrence. Analysis of the literature signifies the association of chronic irritation due to recurrent urinary tract infections being the commonest cause of leukoplakia vesicae. The recommended long-term follow-up and surveillance based on the literature review is by cystoscopy with or without biopsy.     

Sarcoidosis of the bladder: a case report and literature review

A case of bladder sarcoidosis in a woman with known systemic involvement of this disease is reported. The lesion improved and ureteral obstruction was relieved after transurethral resection and systemic corticosteroid treatment. Sarcoidosis and malacoplakia are believed to represent distinct disease processes in the bladder.     

原发性膀胱神经鞘瘤1例报告并文献复习

目的 探讨原发于膀胱的神经鞘瘤和恶性周围神经鞘瘤在组织病理学、临床表现、治疗和预后上的特点,确立两者的鉴别诊断思路.方法 回顾1例原发于膀胱的神经鞘瘤的临床诊疗过程,结合有关膀胱神经鞘瘤及膀胱恶性周围神经鞘瘤的文献资料进行分析.结果 在组织病理和免疫组化方面,原发于膀胱的神经鞘瘤和恶性周围神经鞘瘤有明显差异.结论 原发于膀胱的神经鞘瘤临床极其少见,易与膀胱常见肿瘤混淆,造成误诊,免疫组化为重要的确诊依据.膀胱恶性周围神经鞘瘤应以高度恶性的软组织肉瘤进行处理.临床上应重视两种疾病的鉴别,以正确地指导临床诊疗.     

Complete bladder prolapse: a case report and literature review

Complete bladder prolapse through the urethra is very rare but needs to be recognised early as it can lead to serious complications and requires prompt treatment. Several predisposing factors have been described. A high index of suspicion is required for diagnosis, and the involvement of a multidisciplinary team approach is important in the management of such patients.     

Preoperative embolization of a giant benign phyllodes tumor: A case report and review of literature

Introduction and importancePhyllodes tumors (PT) account for less than 1% of all breast tumors. Giant PTs can lead to breast disfigurement, tumoral ulceration, and bleeding. Outright surgical excision can be challenging or unsafe. Preoperative transarterial embolization (TAE) has a role but data on its use in the management of PT is limited.Case presentationA 43-year-old female presented with a 28 cm fungating, necrotic, benign PT on her left breast that eventually developed tumoral bleeding leading to hemodynamic instability. Preoperative TAE controlled the bleeding and allowed the safe performance of mastectomy. A literature review of preoperative TAE of PTs is also presented including the addition of a chemotherapeutic agent in malignant types.Clinical discussionPTs are rare and comprise only 2.5% of all fibroepithelial breast lesions. Tumoral bleeding causing severe anemia is one of the most common presentations of massive (≥20 cm) PTs, especially when neglected. Indications for preoperative TAE include (1) to halt rapid tumor growth, (2) to control active/persistent tumoral bleeding, and (3) to shrink the tumor size and allow successful resection with negative margins, and avoidance of skin grafting. Post-TAE side effects include fever, chest pain, gradual/expanding tumor necrosis, decrease in tumor weight, and diminished tumoral abscess/discharge, and loss of tumoral vessel elasticity.ConclusionNeglected PTs can reach an alarming size. Preoperative TAE is a safe and effective method of controlling life-threatening tumoral hemorrhage and decreasing the size of PTs thereby allowing definitive resection while avoiding skin grafting and/or flap reconstruction.     

膀胱孤立性纤维瘤1例报告并文献复习

目的:探讨膀胱孤立性纤维瘤(SFT)的临床病理特征、诊断及治疗方法。方法:回顾性分析1例膀胱SFT患者的的临床资料,临床及影像学诊断为膀胱肿瘤,在腰麻下行经尿道膀胱肿瘤电切术,术后出院。1个月后再次来我院复查,在全麻下行经腹腹腔镜下膀胱肿瘤部分切除术。结果:病理检查提示为梭形细胞肿瘤,免疫组织化学检查倾向于SFT。患者腹腔镜术后痊愈出院。结论:膀胱SFT是一种罕见肿瘤,其诊断主要依靠病理学及免疫组织化学检查,手术是其主要治疗方法。     

Primary bladder dermoid: a case report and review of the literature

Bladder dermoid is a rare presentation. Diagnosis of this case was made cystoscopically and confirmed histopathologically. Complete excision was possible endoscopically. This is the 3rd case report from the Indian and Asian subcontinent.     

Simultaneous transurethral resection of a bladder tumor and benign prostatic hyperplasia: Four case reports and literature review

To evaluate the recurrence of a bladder tumor on the prostate fossa and bladder neck in patients undergoing simultaneous transurethral resection of a bladder tumor (TUR-BT) and benign prostatic hyperplasia (BPH) in our hospital, we retrospectively studied four patients who underwent simultaneous TUR-BT and transurethral resection of the prostate (TUR-P) in 2001 to 2004. The pathology was confirmed histologically to be transitional cell carcinoma of the bladder tissue or atypia cells and BPH. Two patients had bladder tumor recurrence at 18 and 33 months during the postoperative follow-up period (10–36 months, with a mean of 18.5 months). One at the bladder neck recurred 33 months postoperatively, and the other in the trigone area, near the bladder neck, recurred after 18 months. After another TUR-BT, there were no more recurrences in these two patients. No tumor progressed to the invasive stage. Tumor recurrence on simultaneous TUR-BT and TUR-P patients is a key issue of concern. We present a brief history of the four patients and a literature review. We concluded that conducting the two procedures simultaneously is clinically feasible for selected patients.     

Merkel cell tumor: a case report and literature review

Merkel cell tumor (MCT) is extremely rare, being discovered so far about 400 cases in literature. It is classified among neuroendocrine tumors. We report a case of MCT in the subclavicular region in a 93 years old woman. We confirm the efficacy of radiotherapy associated with octreotide, which these tumours express specific receptors for.     

肾类癌1例报道并文献复习

目的探讨肾类癌的临床病理特征。方法对1例肾类癌的临床资料进行分析并结合文献复习。结果 59岁女性患者体检时偶然发现无症状左肾肿物,患者无类癌综合征。CT示左肾下极肿物,直径约3.8 cm,边界清楚,强化不明显。患者行经腹膜后途径根治性左肾切除术。免疫组织化学染色显示突触素,CD56,神经元特异性烯醇酶,波形蛋白,CK18呈阳性。病理诊断：左肾类癌T1a期。术后未行辅助治疗,随诊17个月未见肿瘤复发或转移。结论肾类癌极其罕见,确诊依赖病理学及免疫组织化学检查。局限性肾类癌的治疗首选完整的外科切除,其预后相对较好。     

Gunshot bladder trauma: case report and literature review

ObjetiveTo report one case of gunshot bladder trauma and to review its diagnosis and treatment in the related literature.MethodsWe report the case of a 43-year-old-male with an abdominal firearm wound and gross haematuria. Imaging diagnosis by abdominal and pelvic CT and CT-cystography. Surgical treatment.ResultsCT-cystography showed extraperitoneal bladder rupture. Exploratory laparotomy to evaluate for other associated injuries. Bladder wall surgical closure and ureteroneocystostomy with transvesical technique because of complete distal ureter tear. Broad spectrum antibiotherapy. Favourable progress. The patient was discharged at 14th day.ConclusionsFirearm bladder traumas are a rare entity. Surgical exploration and closure is mandatory. In haemodynamicaly stable patients, abdomen and pelvis CT and CT-cystography allow us to rule out associated injuries and to classify the bladder trauma type. Ureteral damage associated in 5- 8,9%, diagnosed during surgical exploration. Broad-spectrum antibiotherapy in all patients.     

Paraspinal desmoid tumor: a case report and a literature review

Aim  Paraspinal desmoid tumors are rare and only few cases have been reported in the literature. This report describes a case of successful excision of a parasacral desmoid tumor in a 34 years old female. Methods  The patient presented with a tender mass over her right sacral region. Radiological examination with CT and MRI demonstrated two adjacent well circumscribed masses measuring 4 × 3 and 2.5 × 3 cm, in the subcutaneous fat of the right paravertebral region. At surgery the patient underwent a wide excision of the lesion, and two tumor masses were dissected away from the gluteus and the multifidus muscles. Histopathologic examination of the specimens confirmed the diagnosis of a desmoid tumor. Results  After surgical resection without adjuvant therapy, the patient is recurrence free after 36 months. Conclusions  Despite their benign microscopic appearance, and their insignificant metastatic potential, the tendency of desmoid tumors for local infiltration is potentially significant causing deformity, morbidity and even mortality, especially when present at the paraspinal area, due to the pressure effects to the close neural structures and the spinal canal as well. Early detection of the neoplasm is crucial, in order to achieve radical excision of the neoplasm before it penetrates vital structures.     

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.     

Intracerebral epidermoid tumor: a case report and review of the literature

BACKGROUND: Intracerebral epidermoid cysts are rare lesions and may account for only 1.5% of intracranial epidermoid tumors. Cell entrapment from the mesectodermal origin of the neural crest within the primitive cerebral hemisphere may lead to the formation of such rare intracerebral lesions. METHODS: An intracerebral epidermoid cyst located in the right temporal lobe that was surgically treated is presented. The origin, clinical course, radiological features, and surgical treatment of such uncommon lesions are discussed based on a review of the literature.RESULTS: Intraoperative findings revealed an epidermoid tumor. The postoperative course was uneventful and the patient was discharged with no neurological deficits. On long-term follow-up (2 years), there were no signs of recurrence. CONCLUSIONS: Truly intracerebral epidermoid tumors are rarely found. Cells originating from mesectodermal lines may migrate and remain trapped within the primitive cerebral hemisphere while the neural tube is closing, leading to the formation of such intraparenchymal epidermoid tumors. Accurate preoperative diagnosis can be very difficult due to the radiological similarities to other common intracerebral cysts (e.g., astrocytomas or gliomas). Magnetic resonance imaging (MRI) studies, especially with diffusion-weighted images, allow greater accuracy in the preoperative differential diagnosis. Radical surgical removal should be attempted, but a less aggressive surgical strategy should be considered if there is strong adherence between the tumor capsule and the brain tissue, particularly in eloquent areas.     

膀胱淋巴管瘤1例报告并文献复习

目的：探讨膀胱淋巴管瘤的临床病理特点与诊治方法。方法：回顾分析1例膀胱淋巴管瘤临床资料,并复习有关文献。结果：经尿道电切和电灼增生及坏死组织灶,病变黏膜下注射平阳霉素,术后肉眼血尿消失,1周后排尿刺激症状明显改善,20天后消失。2个月后巩固治疗一次。随访一年无复发。结论：膀胱淋巴管瘤是一良性肿瘤,主要症状为肉眼血尿,有或无排尿刺激症状,尿中无白细胞,确诊依靠膀胱镜活检,手术和化疗效果理想,预后好。     

Neonatal bladder rupture: case report and review of literature

Neonatal bladder rupture is rare. A review of the literature revealed less than 16 cases. A case of posterior urethral valves and associated neonatal ascites due to bladder perforation is presented.