膀胱肉瘤样癌1例报告及文献复习

The case report about bladder sarcomatoid carcinoma with literature review

目的结合文献报告1例膀胱肉瘤样癌病例。方法对1例老年男性膀胱肉瘤样癌病例进行报道并对文献复习。结果病人男,83岁,以无痛性全程肉眼血尿收入院。CT影像学检查示膀胱内混合密度肿物。膀胱镜检示膀胱内多发肿物。予以膀胱部分切除术治疗。术后病理组织镜检示,癌及肉瘤成分共存,两者间分界明显。术后组织免疫组化检查示CK(-),CK7(-),CK20(-),EMA(+),Vimentin(2+),Desmin(-),CD34(-),Myogenin(-),GATA3(+/-),S-100(-),Melanoma(-),Ki-67(+60%)。据此诊断为膀胱肉瘤样癌。术后第3个月复查全腹CT示膀胱内肿瘤复发及膀胱外转移。术后1年后病人死于肿瘤全身转移。结论膀胱肉瘤样癌病例多数同时表达上皮及间质肿瘤标志物。病例病情进展迅速,预后差。需要加强此类病例资料收集。

Objective The clinical observation about a case of bladder sarcomatoid carcinoma is reported by literatures review.Methods A case about an elderly male patient with bladder sarcomatoid carcinoma is represented while reviewing associated literatures.Results A 83-year-old male was admitted into our hospital in complaint of gross hematuria.CT Image examination showed the bladder mass with mixed density.Therefore,we performed a cystoscopy to identify those leision and found multiple tumor widely spreading in bladder.In view of that,the partial bladder resection was performed.The postoperation immunohistochemical examination showed,CK(-),CK7(-),CK20(-),EMA(+),Vimentin(2+),Desmin(-),CD34(-),Myogenin(-),GATA3(+/-),S-100(-),Melanoma(-),Ki-67(+60%)and the diagnosis of sarcomatoid carcinoma in bladder was established.3 mouth after operation,CT examination revealed recurrence in bladder with extra-vesical metastasis.The patient died one year after operation because of multiple metastasis.Conclusion The bladder sarcomatoid carcioma is a rare biphasic tumor that contains epithelial and mesenchymal components.Such disease develop rapidly with poor prognosis.More attention should be paid on the collection of associated clinical data.