膀胱肉瘤样癌误诊1例报告并文献复习

Sarcomatoid carcinoma and Carcinosarcoma of Urinary Bladder:One Misdiagnostic Case Report and Literature Review

目的:探讨膀胱肉瘤样癌的组织学特性,提高对膀胱肉瘤样癌的诊断治疗水平。方法:报告1例膀胱肉瘤样癌患者的临床、病理资料,复习相关文献进行讨论。结果:术后病理检查见上皮和肉瘤样间质2种恶性成分,癌与肉瘤样区有移行,癌组织CK阳性,Vimentin阴性,肉瘤样组织CK及Vimentin阳性,诊断为膀胱肉瘤样癌。1个月后死于全身衰竭、多处转移。结论:膀胱肉瘤样癌具有浸润性生长的生物学特性,恶性程度高,预后不良,确诊依赖病理学及免疫组织化学检查;化疗、放疗都不太敏感,手术仍是首选治疗方式。

Objective：To investigate the histological essence of the sarcomatoid carcinoma of the urinary bladder, and to improve the diagnoses and treatment for the sarcomatoid carcinoma. Methods ：The clinical and pathological data of 1 patient （male, 66 years）of bladder sarcomatoid carcinoma were reviewed respectively. And the related articles were reviewed. Results：The histopathology showed the tumors with epithelial and sarcomatoid mesenchymal components. The immunohistochemical testing was positive for CK and negative for Vimentin in epithelial cancer area,but positive for CK and Vimentin in sarcomatoid area. The ultimate diagnosis was sarcomatoid carcinoma of the urinary bladder. He died of multi-metastasis, crocking up within 1 months later. Conclusions：Sarcomatoid carcinoma of the urinary bladder has the biological behavior of invasive growth. It is most often in an advanced stage at presentation, leading to an unfavorable prognosis. The ultimate diagnosis dependes on histopathology and immunohistochemical testing and the operation is still the first choice of treatment.