整塊膀胱腫瘤切除術合併化療治療肌肉侵犯性膀胱癌達成完全反應之病例報告

吳尉綱、溫玉清、林雍偉

臺北市立萬芳醫院 泌尿科

En-bloc resection of bladder tumor combined with chemotherapy for muscle invasive bladder cancer potentiate a complete response: A case report

Wei-Kung Wu, Yu-Ching Wen, Yung-Wei Lin

Department of Urology, Wan Fang Hospital, Taipei Medical University

Transurethral resection of bladder tumor is the cornerstone in diagnosis and treatment of bladder tumor. Compared to conventional transurethral resection of bladder cancer, en-bloc resection of bladder tumor, is more likely to reach complete tumor removal.

Here we present a 77-year-old woman with a history of tuberculosis of right kidney who suffered from intermittent hematuria for about a month. Initial urine routine revealed pyuria. Empiric antibiotics were prescribed to treat urinary tract infection but hematuria still presented intermittently. Cystoscopy was then performed and one mass lesion over the right lateral wall with caseous change was found. Cystoscopy biopsy for pathology revealed high grade invasive bladder urothelial carcinoma. Computed tomography presented a 3.6x1.5 cm lesion at the right lateral wall with preserved visceral fat. She then received transurethral laser en-bloc resection of bladder tumor. The pathological report showed muscle invasive urothelial carcinoma of urinary bladder with negative margin. She refused concurrent radiotherapy and definitive treatment with radical cystectomy. 7 courses of adjuvant chemotherapy with gemcitabine and cisplatin were completed. Until now, regular follow-up with cystoscopy and whole-body contrast-enhanced computed tomography showed no local recurrence or metastases for two more years.