脐尿管癌的诊断与治疗(附5例报告)

Diagnosis and treatment of urachal carcinoma(5 case-reports attached)

目的:探讨脐尿管癌的诊断与治疗方法,提高对该病的认识。方法:回顾性分析某院收治的5例脐尿管癌患者的临床资料、随访结果。结果:本组5例患者,男4例,女1例。4例行扩大性膀胱部分切除术,1例行根治性膀胱切除术,5例术中均行双侧盆腔淋巴结清扫。5例术后切缘皆阴性,1例患者发现阳性淋巴结。术后病理诊断为粘液腺癌4例,乳头状腺癌1例。随访半年至3年,1例根治性全膀胱切除患者术后12个月死亡,1例扩大性膀胱部分切除术患者术后7个月复发,并于6个月后死亡。其余3例分别随访6个月,12个月,18个月未见复发及转移。结论:脐尿管癌恶性度高,起病隐匿,预后差。手术是主要的治疗手段。

Objective：To explore the diagnosis and treatment of urachal carcinoma and to improve the recognition of the disease. Methods： Clinical data and outcomes of 5 patients diagnosed as urachal carcinoma were retrospectively reviewed. Results ：4 cases were male, and 1 case was female. 4 of them were treated by extensive partial cystectomy and one of them received radical cystectomy. All cases underwent pelvic lymph node dissection. Bladder margins were negative for cancer in all the 5 cases but positive lymph nodes were found in 1 case. Post-operative bistopathology confirmed urachal adenocarcinoma in 4 cases and papillary in 1 case. The follow-up period was from 6 to 36 months. One patient died from extensive matastasis 12 months after the radical cystectomy. Another patient treated by extensive partial cystectomy died from recurrence 13 months postoperatively. The other 3 cases had been alive without recurrence and metastasis up to the last follow-up period（ 18 months）. Conelusion：Urachal carcinoma is a highly malignant epithelial cancer with poor prognosis. It~ difficult to diagnose earlier and easy to relapse. Surgery is the preferred treatment.