脐尿管小细胞内分泌癌病例的诊断治疗  

Diagnosis and therapy of urachus small cell endocrine cancer

作　　者：高宏伟[1] 刘春雨[1] 韩瑞发[1] 畅继武[1] 史启铎[1] 

机构地区：[1]天津医科大学第二医院泌尿外科研究所,天津300211

出　　处：《中国现代医学杂志》2010年第7期1073-1075,共3页China Journal of Modern Medicine

摘　　要：目的探讨脐尿管小细胞内分泌癌的临床表现及诊治方法。方法脐尿管小细胞内分泌癌患者1例,男性,26岁。因全程肉眼血尿1月入院。泌尿系B超显示膀胱顶部部分凸向膀胱腔。盆腔CT检查提示膀胱顶部偏右侧肿物,向膀胱外凸出。3次尿脱落细胞检查中,可疑瘤细胞1次,未见瘤细胞2次。结果患者行膀胱部分切除术。术后病理回报:脐尿管源性小细胞型内分泌癌,脉管内可见瘤栓,侵肌层及脂肪组织,免疫组织化学染色:NSE阳性。术后患者行MEP方案全身化疗,3月后全身骨转移死亡。结论脐尿管小细胞内分泌癌临床较罕见,临床表现常为肉眼血尿,影像学表现为膀胱肿瘤的特征。外科手术及全身化疗为目前治疗脐尿管小细胞癌的方法,但预后差,病人的生存期短。【Objective】To investigate the clinical features and the management of urachus small cell endocrine cancer.【Methods】One case of urachus small cell endocrine cancer report.The patient was a 26 years old male who was hospitalized because of the entire gross hematuria for 1 month.Ultrasonography showed there was a moderate-intensity echo mass in the bladder dome,and a part of which had extended into the bladder.CT scan found a mass in the right of the bladder dome which had extended out of the cyst.3 times urine exfoliated cells examination showed once suspicious tumor cell and twice negative.【Results】The pathology result showed after partial cystectomy was urachus small cell endocrine cancer.There were tumor embolus in the vascular tissue and the tumor had invaded the muscle and the fat.Immunohistochemistry ：NSE（positive）.The patient was given the chemotherapy by the program of the MEP.And he died because of the bone metastases.【Conclusion】The urachus small cell endocrine cancer was rare in the clinic.Clinical symptoms include hematuria,irritative voiding symptoms,the imaging findings were the same as the bladder tumor.Now the therapy consists surgical and chemotherapy.But the patient with urachus small cell endocrine cancer have poor prognosis and short lifetime.

关 键 词：脐尿管癌 小细胞癌 治疗 

分 类 号：R694[医药卫生—泌尿科学]