膀胱原発小細胞癌の1例

Abstract

A 58-year-old man presented to the Department of Internal Medicine at his local hospital with gross hematuria and miction pain. He was referred to our department because of suspected bladder cancer. Urethrocystoscopy revealed a broad- base nodular mass which was 3 cm in diameter on the anterior wall of the bladder, as well as small papillary masses all over the bladder mucosa. After the clinical diagnosis of cT3aN0M0 was established, TUR-biopsy was performed and pathological examination showed a mixture of small cell carcinoma(SCC), which was ≧ T2, and transitional cell carcinoma (TCC), which was G3, pT1a. After one course of M-VAC as neoadjuvant therapy, radical cystourethrectomy was performed. Pathological examination revealed that the SCC was pT2N0M0 and the TCC was G3, pT1a. Two courses of EP therapy were given postoperatively as adjuvant therapy, but he had the local relapse and the metastases to liver, lurnbar spine, iliac bone, and lung after eight months following the operation. Then one course of EP therapy was given performed ; however, it was not effective. He died from cachexia thirteen months after the operation.