膀胱小细胞神经内分泌癌与鳞癌混合性癌1例并文献复习

Small cell neuroendocrine carcinoma and squamous cell carcinoma of the bladder: A case report and literature review

目的:通过对1例膀胱小细胞神经内分泌癌与鳞癌的混合性癌患者病例的分析,探讨该病的临床特点、病理学特点、临床诊断、治疗方法及预后。方法:回顾性分析遵义医学院附属医院泌尿外科2017年10月收治的1例术后病理组织学诊断为膀胱小细胞神经内分泌癌与鳞癌混合性癌患者的临床资料并进行国内外文献复习。结果:49岁男患,因"发现肉眼血尿2月余"入院,全麻下行腹腔镜根治性膀胱全切+回肠新膀胱+扩大淋巴结清扫术,术后经病理组织学确诊为膀胱混合性癌(小细胞神经内分泌癌+角化型鳞癌)。结论:膀胱小细胞癌(包括其与移行细胞癌、腺癌和鳞癌等复合癌)临床表现主要以肉眼血尿为主,呈现高度的恶性生物学行为,具有发现晚、进展快、转移早、恶性程度高、预后差等特点,需尽早完善病理学诊断,明确肿瘤的临床分期以达到早期治疗与有效改善其预后的目的。

Objective： Through the analysis of a case of mixed cancer in the case of a small bladder cell neuroendocrine carcinoma and squamous carcinoma,the clinical characteristic of the disease,pathology characteristics,clinical diagnosis,treatment and prognosis were explored. Methods： The clinical data of 1 case postoperative histopathological diagnosis of urinary bladder small cell neuroendocrine carcinoma and squamous cell carcinoma in the department of urology of the Affiliated Hospital of Zunyi Medical College in October 2017 were retrospectively analysed and domestic and foreign document reviews were conducted. Results： A 49-year-old male found macrohematuria more than 2 months in hospital. Laparoscopic radical cystectomy and ileum new bladder and expanding lymph nodes dissection were performed under general anesthesia. Postoperative histopathology was diagnosed as bladder mixed carcinoma（ small cell neuroendocrine carcinoma and keratosis squamous cell carcinoma）. Conclusion： Small cell carcinoma of the bladder（ including its combination with transitional cell carcinoma,adenocarcinoma and squamous cell carcinoma） is mainly characterized by gross hematuria and performs highly malignant biological behavior. It has the characteristics of late detection,rapid progress,early metastasis,high malignancy and poor prognosis. It is better to complete the pathological diagnosis and clear the clinical stages of the tumor as soon as possible in order to achieve early treatment and effectively improve its prognosis.