摘要
目的提高对原发性膀胱印戒细胞癌的认识和诊治水平。方法回顾分析我院收治的2例原发性膀胱印戒细胞癌,结合文献就其临床表现、诊断及治疗进行讨论。第1例患者,男,57岁,以全程肉眼血尿和继发的贫血就诊,CT检查示膀胱顶部占位性病变,界限清楚,有斑点状钙化。第2例患者,男,66岁,以黏液尿就诊,无其他临床表现,CT示膀胱右侧壁占位性病变。均于术前膀胱镜活检明确诊断。第1例因患者拒绝膀胱全切除术行膀胱部分切除术加脐尿管和相邻腹膜的切除术,第2例因陈旧性心肌梗塞行膀胱部分切除术。结果第1例患者术后血尿消失,贫血纠正。7个月后发现肺部转移,术后8个月死亡。第2例术后黏液尿和膀胱刺激症状消失。随访37个月,患者恢复良好,无复发和转移。结论原发性膀胱印戒细胞癌临床罕见,预后较差,诊断主要依赖病理学检查,全膀胱切除术是其首选治疗方法。
Objective To report 2 patients of primary signet-ring cell carcinoma（SRCC） of urinary bladder and improve the recognition,diagnosis and treatment of this disease.Methods Two patients of primary SRCC of urinary bladder were reported with review of the literature.The first male patient,aged 57 years,whose chief complain was totally gross hematuria and secondary anemia.CT and cystoscopy showed a sharp-demarcated tumour with stippled calcifications in the dome of the bladder.The second male patient,aged 66,was admitted with a chief complaint of mucin discharge and urinary irritation.CT and cystoscopy showed a tumour in the right wall of the bladder.The diagnosis of primary SRCC of the urinary bladder of the two cases was made by cystoscopic biopsy before the surgery.Partial cystectomy with en bloc resection of the umbilical ligments and urachus was done in the first patient because the patient did not want cystectomy.The second patient underwent partial cystectomy because of obsolete myocardial infarction.Results The hematuria of the first patient disappeared and the anemia was corrected after the surgery.The patient died of pulmonary metestasis 8 months after surgery.The mucin discharge and bladder irritation of the second patient disappeared gradually after the surgery and lived well with free survival of the disease after a follow-up of 37 months.Conclusions Primary SRCC of the urinary bladder is a rare malignant tumour with poor prognosis,which diagnosis depends on pathologic examination.Radical cystectomy is the best treatment of choice.
出处
《中华腔镜泌尿外科杂志（电子版）》
2011年第1期38-40,共3页
Chinese Journal of Endourology(Electronic Edition)
关键词
膀胱肿瘤
印戒细胞癌
原发性
Bladder neoplasms
Signet-ring cell carcinoma
Primary
