Podium 01
病例報告：膀胱憩室內尿路上皮癌伴隨巨大前列腺
羅偉恩、王曉暹、黃家倫、楊景偉、陳光國、張心湜、蔡昇翰、謝啟誠
振興醫療財團法人振興醫院泌尿部
Case Report: Large Intradiverticular urothelial carcinoma with Giant Prostate
Wei-En Luo, Hsiao-Hsian Wang, Chia-Lun Huang, Chin-Wei Yang, Kuang-Kuo Chen, Luke S. Chang, Sheng-Han Tsai, Chieh-Chen Hsieh
Department of Urology, Cheng Hsin General Hospital, Taipei, Taiwan
Case presentation:
A 68-year old male suffered from painless gross hematuria for 2 days visited urology outpatient department for help. Urine analysis revealed RBC>100/HPF, WBC= 6-9/HPF. Abdominal CT showed huge prostate with size of 8 x 9 x 10 cm and bladder diverticulum with suspicious mass. The patient received bladder biopsy, which pathology showed Non-invasive papillary urothelial carcinoma, high-grade. The patient underwent robotic assisted partial cystectomy and the pathologist reported an invasive urothelial carcinoma, high-grade. After surgery, the patient referred to oncologist for further treatment and chemotherapy.
Discussion:
Bladder diverticula are protrusions of the bladder urothelium and mucosa via muscle fibers of the bladder wall, the muscularis propria, which results in a thin-walled structure connected to the bladder lumen and poorly empties during micturition. Although most of the diverticula are benign, they may also cause calculus, infection or even complicated with neoplasms. Intradiverticular urothelial carcinoma is rare with an incidence of 0.8%-10%. They are more common in elderly men with painless hematuria as the predominant presenting symptom. Tumors in bladder diverticula may be difficult to detect and resect. The patient also suffered from a huge prostate which may cause even more difficulty. Therefore, partial cystectomy is considered as feasible surgical method to not only resect the tumor but also the large diverticulum. Further systemic therapy will be administered for the control of disease progression.