原发性膀胱类癌瘤(附四例报告)

Primary carcinoid tumor of the urinary bladder(report of 4 cases)

目的 探讨原发性膀胱类癌瘤的临床特征、诊断和处理方法。 方法 对 4例原发性膀胱类癌瘤的病理和临床资料进行回顾性分析。男 3例 ,女 1例 ,平均年龄 58岁。患者均有肉眼或镜下血尿 ,但无类癌综合征表现 ,其中尿脱落细胞检查癌细胞阳性 1例 ,KUB加IVU检查发现膀胱腔内充盈缺损 1例 ,B超检查发现膀胱腔内新生物 3例 ,膀胱镜检查均发现息肉样新生物 ,大小为 0 .5cm× 0 .5cm～ 4.0cm× 3 .0cm ,1例伴盆腔淋巴结肿大。 结果 3例行经尿道电切除术者 (膀胱类瘤2例 ,膀胱类癌 1例 ) ,分别随访 1、2、3年 ,未见复发。 1例晚期膀胱类癌患者行根治性膀胱切除、回肠代膀胱术 ,术后 3个月胸片示双肺转移 ,辅以放疗和化疗 2个疗程 ,2个月后死亡。 结论 原发性膀胱类癌瘤无明显特异性症状 ,确诊依靠病理。手术切除是治疗该病的主要方法 ,膀胱类瘤预后良好 。

ObjectiveTo present 4 cases of primary c ar cinoid tumor of urinary bladder and to discuss the characteristics,diagnosis,tre atment and prognosis.MethodsA retrospective study of p athological and clinical data of 4 cases of primary bladder carcinoid tumor was made.Three were male patients and 1 female with an average age of 58.Two cases w ere considered as benign carcinoid tumor whereas the other 2 carcinoid of high malignancy.All of them presented macroscopic or microscopic hematuria but with no carcinoid syndrome noted.ResultsOne case of maligna nt carcinoid tumor with deep muscle invasion underwent radical cystoprostatectom y and adjurvent chemotherapy,but the prognosis was poor (died 5 months after the operation).Transurethral resection were performed for 2 cases of benign carcino id tumor and 1 case of focal malignant carcinoid with good prognosis.ConclusionsThe primary carcinoid tumor of urinary bladder has no specific symptoms,and should be diagnosised on histopathologic studies.Surgical intervention is the mainstay to treat the disease but the prognosis is hard to b e predicted.