尿路复合性恶性肿瘤(附21例报告)

Mixed malignant tumor of the urinary tract

报告２１例尿路复合性恶性肿瘤，位于肾盂２例，膀胱１９例。主要临床表现为血尿，绝大多数病人伴有尿路刺激症状。低分化的移行细胞癌（ＴＣＣ）与继发性复合肿瘤有密切关系。２１例中１例为ＴＣＣ复合肉瘤，１１例为ＴＣＣ复合鳞癌，７例为ＴＣＣ复合腺癌，２例为腺癌复合鳞癌。本组２例肾盂肿瘤分别行肾输尿管全长加膀胱袖口状切除术和肾部分切除术，术后存活６个月和１年；膀胱肿瘤１４例行膀胱部分切除术，已生存３年４例，１年２例，未满１年２例，３例１～２年内死亡，失访３例；２例根治性膀胱全切术已生存５年和３年以上；３例行ＴＵＲＢｔ，已生存３年１例，１５年１例，未满１年１例。对尿路复合性恶性肿瘤的组织学、临床和病理特征进行了讨论。

cases of mixed malignant tumor of the urinary tract were presanted.The mixed tumor was located in the pelvic in 2 and in the bladder in 19.Haematuria was usually the chief presenting symptom,while vesical irritability was present in most patients.Histologically,the tumor was composed of high grade TCC admixed with sarcomatous compoments in 1,TCC with squamous cell carcinoma(SCC)in 11,TCC with adenocarcinoma in 7 and adenocarcinoma with SCC in 2.All of the patients underwent surgical treatment.For the 2 pelvic cases,Nephro ureterectomy with removal of a cuff of adjacent bladder was performed in 1 and partial nephrectomy was in the other.For the bladder cases,was performent in 14,radical cystectomy in 2 and TURBt in 3.Longer survival was abserved in those who underwent radical surgery.The histogenesis,clinical and pathologic characteristics of the mixed tumor were discussed in detail.