膀胱偶发肿瘤的的诊断与治疗

Diagnosis and treatment of incidental bladder tumor

背景与目的:膀胱偶发肿瘤的国内外报道较少,有必要总结一下膀胱偶发肿瘤的临床特点,以提高膀胱偶发肿瘤的诊治水平。方法:回顾性分析11例膀胱偶发肿瘤的临床资料。常规体检B超发现6例,膀胱镜下置放或拔双J管发现3例,经尿道前列腺电切(TURP)术中发现2例,肿瘤直径0.2～1.5cm。结果:11例均行经尿道膀胱肿瘤电切(TURBT)术,术后病理:乳头状瘤1例,内翻性乳头状瘤2例,乳头状低度恶性倾向的尿路上皮肿瘤3例,低级别的乳头状尿路上皮癌5例。所有膀胱癌患者TURBT术后接受即刻单剂膀胱灌注化疗,术后定期膀胱镜复查。随访半年至10年,复发1例。结论:膀胱偶发肿瘤中膀胱癌多见,但恶性程度低,肿瘤表浅,预后良好,术后复发率低。

Background and purpose： Incidental bladder tumor is rarely reported both here and abroad, therefore it is necessary, to sum up the diagnosis and treatment of the incidental bladder tumor and evaluate the clinical character of the incidental bladder tumor. Methods： 11 cases of incidental bladder tumor that had been incidentally detected were reviewed, in which 6 cases were found by B ultrasonic scan, 3 cases by incidental cystoscopy which was used to insert or pull out double J tubes, 2 cases by TURP . The size of tumors ranges from 0.2 to 1.5 cm. Results： TURBT is performed for all the cases, the post-operative pathology were one case papilloma , two cases inverted papilloma, three cases papillary urothelial neoplasm of low malignant potential（PUNLMP）, five cases low -grade papillary urothelial carcinoma. All cases of punlmp and low-grade cancer received an immediate single instillation with a chemotherapeutic drug and routine cystoscopy follow up, one case recurred after the follow up from six months to ten years. Conclusions： Incidental bladder carcinoma is the common type of incidental bladder tumor which is often superficial with low malignancy and good prognosis. The frequency of recurrence after operation is very low.