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目的总结膀胱非上皮肿瘤的诊治经验。方法回顾性分析1998~2013年收治的30例膀胱非上皮肿瘤临床资料。男11例,女19例。年龄6~77岁,主要临床表现为:尿频、排尿困难、肉眼血尿、盆腔肿块、排尿晕厥等。结果 3例行经尿道膀胱肿瘤电切术,21例行膀胱部分切除术,2例行全膀胱切除术,无法手术4例,恶性肿瘤术后辅助化疗或放疗。随访10个月~15年,良性肿瘤均无复发,恶性肿瘤中恶性嗜铬细胞瘤1例、淋巴瘤3例随访1~2年至今仍存活,神经内分泌癌1例、癌肉瘤2例、小细胞恶性肿瘤1例、平滑肌肉瘤1例,随访2~6个月内复发、死亡。结论膀胱非尿路上皮肿瘤临床少见,B超引导下深部活检可提高诊断率,良性肿瘤预后较好,可行膀胱部分切除术,应完整切除,恶性肿瘤应争取全膀胱切除,结合病理特点辅助化疗或放疗,可提高疗效。
Objective To summarize the diagnosis and treatment of bladder non-epithelial tumors. Methods The clinical data of 30 cases of non-epithelial bladder tumor from 1998 to 2013 were retrospectively analyzed. There were 11 males and 19 females. Age 6 to 77 years old, the main clinical manifestations: frequent urination, dysuria, gross hematuria, pelvic mass, micturition, syncope. Results Three cases underwent transurethral resection of the bladder tumor, 21 underwent partial cystectomy, two underwent total cystectomy, four cases failed surgery, and postoperative adjuvant chemotherapy or radiotherapy for malignant tumors. Follow-up of 10 months to 15 years, no recurrence of benign tumors, malignant pheochromocytoma in 1 case, 3 cases of lymphoma were followed up for 1 to 2 years still alive, 1 case of neuroendocrine carcinoma, 2 cases of carcinosarcoma, small One case of malignant tumor cells, one case of leiomyosarcoma, recurrence within 2 to 6 months follow-up, died. Conclusions Bladder non-urothelial tumors are rare, deep biopsy under B-ultrasound can improve the diagnostic rate, good prognosis of benign tumors, feasible partial resection of the bladder should be completely removed, malignant tumors should be cystectomy, combined with pathological features of adjuvant chemotherapy Or radiotherapy, can improve the curative effect.