膀胱非上皮性肿瘤25例诊治报告

目的 总结膀胱非上皮性肿瘤的影像及临床诊断特点,探讨治疗方法与预后的关系.方法 回顾性分析25例膀胱非上皮肿瘤临床资料.男16例,女9例.年龄2～71岁.其中血尿6例,下腹部肿块2例,尿频14例,排尿困难2例,排尿晕厥1例.超声及CT检查发现22例膀胱占位病变,3例盆腔肿物及膀胱壁受累.均行膀胱镜检查,穿刺活检17例.结果 15例良性肿瘤行单纯肿瘤剜除术或膀胱部分切除术;10例恶性肿瘤行膀胱部分切除术或膀胱全切术.恶性肿瘤术后辅助化疗、放疗.随访3个月～11年.良性肿瘤均无复发,恶性肿瘤9例死于术后3年内,平均存活16个月;1例膀胱恶性淋巴瘤带瘤存活6年.结论 膀胱非上皮性肿瘤临床上少见,病理类型复杂,恶性居多,预后较差.膀胱部分切除术或膀胱全切术是本病的主要治疗方法,恶性肿瘤结合其病理特点辅助放化疗,疗效不理想,预后差别较大.

Diagnosis and treatment of bladder non-epithelial tumors ( report of 25 cases)

Objective To summarize the characteristics of images and clinical diagnosis of bladdernon-epithelial tumors,and to investigate the relationship between the therapeutic methods and prognosis of thedisease. Methods The clinical data of 25 patients (16 males and 9 females,aged between 2 -71 years)with bladder non-epithelial tumors treated in our hospital were retrospectively analyzed.The clinical manifes-tations included hematuria (6 patients),lower abdominal lump (2),frequent urination (14),dysuria (2)and fainting during voiding (1).Ultrasound and CT examinations suggested space-occupying lesions in thebladder in 22 patients and pelvic tumor involving the bladder wall in the other3 patients.Cystoscopy was per-formed in all patients and 17 patients got biopsy. Results Simple tumor resection or partial cystectomywas carried out in 15 patients with benign tumors;the rest 10 patients with malignant tumors underwent par-tial or radical cystectomy. Adjuvant radiotherapy and chemotherapy were performed in malignant tumor pa-tients.Follow-up time was 3 months to 11years.No recurrence was found in benign tumor patients.Nine pa-tients with malignant tumors died in 3 years after operation (mean survival time of 16 months).A patientwith bladder malignant lymphoma survived for6 years.Three recurrences occurred in another bladder leiomy-osarcoma patient who had tumor resection. Conclusions Bladder non-epithelial tumors are relatively rarein clinical.The pathological types of the tumors are complicated,most of them are malignant and the progno-sis is relatively poor.The clinical perception of these tumors is inadequate and misdiagnosis rate is high.Deep-site biopsy under cystoscope can improve the diagnostic rate.Partial or radical cystectomy is the maintherapy for these tumors,and adjuvant radiotherapy and chemotherapy can be used according to the pathologi-cal features, but the effects are uncertain and the prognosis is quite different.