膀胱和前列腺类癌并前列腺腺癌1例报告并文献复习

Carcinoid tumor of urinary bladder and prostate accompanied with adenocarcinoma:a case report and literature review

目的:探讨膀胱、前列腺类癌并前列腺腺癌的临床诊治及组织学特征,提高对该病的认识。方法:回顾性分析1例膀胱、前列腺类癌并前列腺腺癌患者的临床资料,复习有关文献,分析该肿瘤的临床特点、免疫组织化学特征、诊治及预后情况。结果:通过病理确诊后采用腹腔镜下根治性膀胱切除+回肠输出道术,术后病理为膀胱、前列腺类癌并前列腺腺癌。免疫组织化学显示:膀胱、前列腺类癌异型细胞CK部分+,CgA+,Syn+,CD56-,P63-,LCA-;前列腺局灶腺癌Gleason为5+4=9,PSA部分+,P504S+,P63-,34βE12-,CK-。术后恢复良好,随访至今已4个月,无复发。结论:膀胱、前列腺类癌临床罕见,无特异性临床表现,而合并前列腺腺癌更为罕见,其独特的组织学特征是确诊的关键;根治切除术是治疗本病有效、可靠的手段,远期预后不佳。

Objective： To investigate the clinical and histological features of bladder and prostatic carcinoid tumor accompanied with adenocarcinoma of the prostate, to enhance the understanding of the disease. Methods： Retrospective analysis of a case of bladder and prostatic carcinoid tumor accompanied with adenocarcinoma of the prostate was taken by reviewing related literature, analyzing the clinical features, immunohistochemical character- istics, treatment and prognosis. Results： The case was treated by laparoscopic radical cystectomy and ileal conduit after cystoscopic biopsy. Immunohistochemistry revealed that the cancer cells were positive for part of CK, CgA and Syn, while CD56, P63 and LCA were negative. Gleason score showed 5＋4=9. The cancer cells were positive of prostate focal adenocarcinoma for PSA and P504S, while P63, 3413E12 and CK were negative. With the follow- up of 4 months, no recurrence occurred. Conclusion： Carcinoid tumor of urinary bladder and prostate are rare, ac- companied with adenocarcinoma of the prostate are extremely rare. Distinctive histological features is a critical point in diagnosis,. Radical resection is an effective treatment. However, it showed poor prognosis.