膀胱肉瘤样癌1例病例报道及研究进展  

Sarcomatoid carcinoma of the bladder: a case report and research progress

作　　者：韩皓名 孔朝辉 王蓬勃 张汉青 HAN Hao-ming;KONG Zhao-hui;WANG Peng-bo;ZHANG Han-qing(Henan Universitly People’s Hospital,Zhengzhou 450003,China)

机构地区：[1]河南大学人民医院,郑州450003

出　　处：《医药论坛杂志》2023年第1期30-33,共4页Journal of Medical Forum

摘　　要：目的 报告1例膀胱肉瘤样癌病例并分析该疾病当前研究现状。方法 回顾性分析2022年3月河南省人民医院收治的1例膀胱肉瘤样癌患者的诊治资料,结合相关文献复习,分析此病的临床表现、诊断标准、病理特点、免疫组化、治疗及预后。结果 患者,男,56岁,以无痛性全程肉眼血尿收入院。肾动态显像提示右肾血流灌注减低,功能重度受损,右侧GFR 23.94 mL/min。CT提示膀胱内不规则团块状软组织密度影,患者及家属拒绝进一步膀胱镜检查,遂与家属沟通后行膀胱根治切除+回肠代膀胱术,术后病理回示根据镜下形态及免疫组化,符合肉瘤样癌。免疫组化:P53(弱+),GATA-3(+),Ki67(约60%+),Vimentin(+),Uroplakin Ⅲ(+)。结论 膀胱肉瘤样癌由癌性和肉瘤性细胞成分组成,具有更强的侵袭性。目前关于此类报道和研究较少,因此需要多机构提供关于膀胱肉瘤样癌的临床研究,为其诊断,治疗建立一套标准的方案。Objective To report a case of sarcomatoid carcinoma of the bladder and analyze the current research status of this disease. Methods The diagnosis and treatment data of a patient with sarcomatoid carcinoma of the bladder admitted to Henan Provincial People’s Hospital in March 2022 were retrospectively analyzed. The clinical manifestations, diagnostic criteria, pathological features, immunohistochemistry, treatment and prognosis of the disease were analyzed combined with relevant literature review. Results A 56-year-old male patient was admitted to the hospital with painless gross hematuria. Renal dynamic imaging showed that the right renal blood perfusion was decreased and the function was severely impaired, and the right GFR was 23.94 mL/min. CT showed irregular mass soft tissue density shadow in bladdor. The patient and his family refused further cystoscopy. After communication with his family, radical cystectomy and ileal bladder replacement were performed. The postoperative pathological findings were consistent with sarcomatoid carcinoma according to the microscopic morphology and immunohistochemistry. Immunohistochemistry: P53(weak +), GATA-3(+), Ki67(about 60%+), Vimentin(+), Uroplakin III(+). Conclusion The sarcomatoid carcinoma of the bladder is composed of cancerous and sarcomatous cell components and is more aggressive. At present, there are few reports and studies on this kind of cancer. Therefore, it is necessary to provide clinical studies on sarcomatoid carcinoma of the bladder from multiple institutions to establish a standard regimen for its diagnosis and treatment.

关 键 词：膀胱肿瘤 肉瘤样癌 诊断 根治性膀胱切除 文献复习 

分 类 号：R737.14[医药卫生—肿瘤]