膀胱移行细胞癌皮肤转移1例

患者女,83岁。外阴起皮疹1个月,破溃半月。5个月前因"膀胱移行细胞癌"行膀胱肿瘤切除术及左侧输尿管成形术。术后定期行膀胱灌注丝裂霉素化疗。2个月前再次出现肉眼血尿伴血块。1个月前无明显原因右侧大阴唇出现一约蚕豆大淡红色结节,无不适,但增长较快,半个月前结节中央破溃。家族中无类似病史。外阴皮疹组织病理示:表皮大致正常,真皮内可见异形性显著的移行细胞性肿瘤细胞团块,胞浆淡染,部分血管内可见癌栓。免疫组化示:CK7(+),HMB45(-)。诊断:膀胱移行细胞癌皮肤转移。

A Case Report: Cutaneous Metastasis from Bladder Transitional Cell Carcinoma

A 83-year-old lady had 1-month history of skin lesion on external genitalia, and half-a-month history of the lesion ulceration. The patient received surgical ablation of bladder tumor and left-ureteroplasty due to bladder transitional cell carcinoma (BTCC) 5 month ago. Intravesical mitomycin therapy was applied to her at regular intervals after operation. The patient had visible hematuria with blood clots again 2 month ago. One horsebean-sized, pinky nodule was found in the right labium major without significant inducements 1 month ago. The patient had not discomforts. The nodule expanded rapidly and ulcerated in the middle of it half a month ago. There was not the same sickness in the patient′s family history. The histopathology of skin lesion on external genitalia showed the epidermis was normal approximately, there were masses of transitional-cellular tumor cells in the dermis which were obviously heteromorphous, the cytoplasm of tumor cells was brightly stained, there were tumor embolus in some blood vessels. The immunohistochemistry staining showed CK7 expression was positive and HMB45 expression was negative in the tumor cells. The patient was diagnosed as cutaneous metastasis from BTCC.