脐尿管癌11例诊治分析

Diagnosis and Treatment of Urachal Carcinoma:a Report of 11 Cases

目的探讨脐尿管癌的诊断、治疗及方法。方法回顾性分析11例脐尿管癌患者的临床症状、影像学特点、治疗和随访结果。结果 11例脐尿管癌中黏液腺癌9例,腺癌2例。Ⅱ期1例、Ⅲ期9例、Ⅳ期1例。1例经尿道行膀胱肿瘤电切术,于术后2个月肿瘤复发,复发后7个月死亡;2例膀胱部分切除者分别于术后3、4个月复发和(或)转移,并分别于肿瘤复发后2、11个月后死亡;2例膀胱全切患者术后1.2、2年死于肿瘤复发;6例行扩大性膀胱部分切除术,其中4例术后1.1～2.1年死亡,1例术后5年无瘤生存,1例术后1.4年,仍在随访中。结论脐尿管癌发病位置隐匿,早期诊断较为困难,易误诊。主要治疗方法是扩大性膀胱部分切除术。脐尿管癌预后很差。

Objective To discuss the diagnosis and treatment of urachal carcinoma.Methods Clinical date,image,Treatment and follow-up data of 11 patients with urachal carcinoma were retrospectively reviewed.Results 9 cases were mucinous adenocarcinoma and the other two were adenocarcinoma.1 patient had stage Ⅱ,9 had stage Ⅲ and 1 had stage Ⅳ disease.Of the 11 patients,1 received TURB and recurrenced at 2 months after operation,and died 7 months after recurrence.2 received partial cystectomy and relapsed at 3 and 4 months after operation.The patients died 2 and 11months after recurrence.2 were treated by radical cystectomy and later died from recurrence after 1.2 and 2 years.6 patients were treated by extensive partial cystectomy,of which 4 died at 1.1 to 2.1 years after operation;other 2 patients remained alive up to the last follow-up,including one survived over 5 years and the other survived 1.4 years after operation.Conclusion Early diagnoses are difficult for urachal carcinoma due to its hidden original location.Extensive partial cystectomy might be the treatment choice.The prognosis of urachal carcinoma is poor.