起源於膀胱子宮內膜異位症的原發性腺癌
郭謹瑋、林介山、嚴孟意、江恆杰
彰化基督教醫院 外科部 泌尿科
Primary clear cell adenocarcinoma derived from endometriosis of urinary bladder
Chin-Wei Kuo, Jen-Sen Lin, Meng-Yi Yan, Heng-Chieh Chiang
Divisions of Urology, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan
Introduction:
Clear cell adenocarcinoma was reported in some article before, and it is an uncommon lesion of urinary bladder cancer. However, to our knowledge, primary clear cell adenocarcinoma which was derived from endometriosis within urinary bladder is extremely rare. And we present our case who was diagnosed as primary clear cell adenocarcinoma which was derived from endometriosis in urinary bladder
Case report:
A 53 y/o female went to our URO OPD due to intermittent hematuria, accompanied symptom including lower abdominal discomfort during mense. The Cystoscopy revealed urinary bladder dorm tumor. Biopsy result showed atypical epithelial proliferation. TURBT was arranged for this problem, the pathological result revealed clear cell adenocarcinoma surrounded by endometriosis. Due to this reason, gynecologist was consulted. Hysterectomy and oophorectomy was arranged. Pathological result showed benign transformation. Because of above finding, primary clear cell adenocarcinoma from urinary bladder endometriosis was diagnosed.
Discussion:
Endometriosis was thought as benign lesion, however, malignant transformation had been revealed by some article. In this case, it may could be one evidence that urinary bladder endometriosis may become malignancy automatically. And persistent urine stimulation may be carcinogenesis to urinary bladder endometriosis.
Conclusion:
Endometriosis of urinary bladder should be advised to follow up regularly because of the potential risk of malignant transformation. .