膀胱中肾腺癌三例报告

Mesonephric adenocarcinoma of the bladder (report of 3 cases)

目的 探讨膀胱中肾腺癌的临床病理特征和诊治方法。 方法 总结 3例病人资料 ,结合文献复习讨论。 结果 3例均有无痛性肉眼血尿症状 ,膀胱镜检发现新生物。病理学检查可见肿瘤由乳头状和腺样结构组成 ,有的细胞似靴钉样 ,以透明细胞为主。细胞异型性明显 ,核分裂相多见。 1例行全膀胱切除、输尿管乙状结肠吻合术 ,1年后阴道壁出现肿瘤转移。 1例行膀胱肿瘤电切术 ,术后 3个月未见肿瘤复发。 1例病人拒绝手术。 结论 膀胱中肾腺癌临床罕见 ,诊断主要依靠病理学检查 ,此病预后较差 ,应作全膀胱切除术。

Objective To study the clinical manifestions and histopathological charateristics of mesonephric adenocarcinoma of bladder. Methods 3 cases of mesonephric adenocarcinoma of the bladder were reviewed with review of the literature. Results Gross hematuria has been the cardinal manifestation in all the 3 with a neoplastic mass found on cystoscopy.Histologically,the tumor were composed of palliary and glandular structures with clear cell features. Some cells were hobnail shaped.One of the 3 underwent total cystectomy with ureterosigmoidostomy. A vaginal metastasis occured one year after operation.One case underwent resection of bladder tumor and was tumor free 3 monthes postoperation.The other patient refused open operation. Conclusions Mesonephric adenocarcinoma of the bladder is very rare,its diagnosis depends on pathologic examination. As the prognosis is bed, total cystectomy should be adopted.