膀胱腎源性腺瘤之案例報告

¹廖家亨、¹莊梓昱

¹臺北市立聯合醫院忠孝院區外科部泌尿科

Nephrogenic adenoma of the urinary bladder: a case report

¹Chia-Heng Liao, ¹Tzu-Yu Chuang

¹Division of Urology, Department of Surgery, Taipei City Hospital, Zhongxiao Branch, Taipei, Taiwan

Introduction

Nephrogenic adenoma, also called nephrogenic metaplasia, is an uncommon benign tumor that can be found in urinary tract. The predisposing factors of this tumor are yet fully understood. Many studies believed that it may be caused by chronic irritation of the urothelium and will be caused by recurrent urinary tract infection, chronic urinary catheterization, intravesical chemotherapy, and so on. Cystoscopically, nephrogenic adenoma may be difficult to distinguish from other malignant neoplasms, and may need immunohistochemical staining for detailing examination. Here we presented a 57-year-old man with urinary bladder tumor diagnosed as nephrogenic adenoma.

Case report

This 57-year-old male had history of traumatic intracranial cerebral hemorrhage with left paralysis under be-ridden status and benign prostate hyperplasia with long-term urinary catheterization. He was first brought to our emergency room for difficulty in foley catheter change. Our urologist was consulted and image survey showed bladder thickening with suspecting bladder stone or other bladder lesion with calcification. Cystoscope was then arranged and diffused papillary tumor was found over broad urinary bladder. Tumor resection was done and histological examination was diagnosed as nephrogenic adenoma. Two months later secondary cystoscope was performed and residual tumor was resected again without malignant lesion but still nephrogenic adenoma diagnosed. The patient had smooth urinary catheter drainage without other complication after two times of tumor resection. However, before the next scheduled follow-up, he was sent back to our emergency room for fever and dyspnea suspecting pneumonia. The patient expired soon after Do Not Resuscitate order was made by his parents.

Conclusion