膀胱炎性肌纤维母细胞瘤2例报告并文献复习

Bladder inflammatory myofibroblastic tumor:report of 2 cases and review of the literatures

目的:探讨膀胱炎性肌纤维母细胞瘤的临床、病理、组织生化特性和诊治方法及预后。方法:报告2例肉眼血尿伴重度贫血的膀胱炎性肌纤维母细胞瘤患者的诊治资料,并结合文献进行探讨。结果:膀胱炎性肌纤维母细胞瘤以肉眼血尿和尿痛为最常见症状,肿瘤好发于膀胱底部、顶壁、侧壁;组织学由具有平滑肌细胞和纤维母细胞特征的梭形细胞、大量慢性炎性细胞及血管样黏液构成。1例随访3年,1例随访6个月,均无瘤存活。结论:膀胱炎性肌纤维母细胞瘤为低度恶性肿瘤,罕见。确诊依据病理学检查,应与平滑肌肉瘤、横纹肌肉瘤、梭形细胞癌等鉴别;治疗原则以切除肿瘤、保留膀胱功能为主,TUPKBT、TURBT或膀胱部分切除术,术后辅以化疗药物膀胱灌注,效果佳。

Objective：To review the pathological, histochemical and clinical features of inflammatory myofibro- blastic tumor of the urinary bladder, and to discuss its diagnosis, treatment and prognosis. Methods：Data of 2 ca ses of bladder IMT with gross hematuria and severe anemia were retrospectively reviewed. Results： The common symptoms of bladder IMT included hematuria and irritative voiding. All bladder masses were located in the bot- tom, top and lateral wall of the bladder. Histologic examination showed the tumor cells consisted of spindle cells, chronic inflammmatory cells and myxoid background with delicate vasculature. After 3 years of follow-up, one pa- tient remained asymptomatic without evidence of recurrence; After 6 months of follow-up, one patient remained a- symptomatic without evidence of recurrence. Conclusion： Inflammatory myofibroblastic tumor of bladder has low potential malignancy. The inflammatory myofibroblastic tumor of the urinary bladder is rare. The diagnosis mainly depends on pathological diagnosis. It should be differentiated from the leiomyosarcoma and the rhabdomyosarcoma and other spindle cell sarcomas. Management of such tumor involves local resection by TURBT or TUPKBT or open surgery with bladder preservation and bladder irrigation with chemotherapeutic agents postoperatively.