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目的探讨膀胱肉瘤样癌的临床特点及治疗方法,以提高对膀胱肉瘤样癌的诊治水平。方法回顾性分析2例膀胱肉瘤样癌患者的临床资料,并进行相关文献复习。结果 2例患者首发症状均为无痛性肉眼血尿,膀胱镜、CT及超声检查均提示膀胱肿瘤。行经尿道膀胱肿瘤电切术,术后病理结果为膀胱肉瘤样癌。免疫组化显示波形蛋白(+)、广谱角蛋白(+)、癌胚抗原(+)。1例患者行超选择性双侧髂内动脉栓塞术,8个月后因多处转移、全身器官衰竭而死亡。另1例行化疗及膀胱灌注治疗,目前6个月随访中。结论膀胱肉瘤样癌恶性程度高,浸润程度深、范围广,侵袭性极强、进展速度极快,预后不良,确诊依靠组织病理学及免疫组化,手术治疗仍是首选治疗方式。
Objective To investigate the clinical features and treatment of bladder sarcomatoid carcinoma in order to improve the diagnosis and treatment of bladder sarcomatoid carcinoma. Methods The clinical data of 2 cases of bladder sarcomatoid carcinoma were analyzed retrospectively and the related literatures were reviewed. Results The initial symptoms of 2 patients were all painless gross hematuria. Cystoscopy, CT and ultrasonography showed bladder tumor. Transurethral resection of bladder tumor resection, postoperative pathological results of bladder sarcomatoid carcinoma. Immunohistochemistry showed vimentin (+), broad-spectrum keratin (+), carcinoembryonic antigen (+). One patient underwent superselective bilateral internal iliac artery embolization and died of multiple organ failure and organ failure after 8 months. Another case of chemotherapy and bladder irrigation treatment, the current 6-month follow-up. Conclusions Bladder sarcomatoid carcinoma of the bladder is highly malignant and has a deep infiltration degree, a wide range of invasion, strong invasion, rapid progression and poor prognosis. It is still the first choice for the diagnosis of bladder carcinoma depending on histopathology and immunohistochemistry.