罕見模仿臍尿管腫瘤之膀胱血管瘤:
-病例和文獻回顧
詹凱勝1、溫玉清1*、蕭志豪1、陳威宇2、李良明1
臺北醫學大學市立萬芳醫院泌尿科
臺北醫學大學市立萬芳醫院病理科
A rare case of bladder hemangioma mimicking urachal tumor: a case and literature review
Kai-Sheng Chan, Yu-Ching Wen, Chi-Hao Hsiao, Wei-Yu Chen, Liang-Ming Lee
1. Department of Urology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
2. Department of Pathology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
We present a case of a 18 year-old male with sudden onset of painless gross hematuria for one month. Intravenous urography showed coarse trabeculation of bladder and cystoscopy revealed an ovoid tumor with blood clots at anterior wall. Then abdominal CT reported a 3.6cm mass lesion at superior anterior wall of bladder suspecting urachus tumor. Initial pathology report from TURBT showed chronic inflammation. En bloc resection including partial bladder and urachus was performed under the diagnosis of urachal tumor. The final pathological report disclosed cavergnous hemangioma of urinary bladder. Cystoscopy and abdominal CT examination follow up in three months showed no local recurrence of hemangioma.
Hemangioma of urinary bladder is uncommon and represent about 0.6% of bladder tumors. It is thought to be congenital in origin arising from embryonic angioblastic stem cells. Three histological types, cavernous, capillary, and arteriovenous, are known to date with cavernous type being the most common type. It predominates in male population with age < 30 years. Common symptoms included painless macroscopic hematuria, irritative voiding symptoms and abdominal pain. Most of the hemangiomas are solitary, small (<3cm), and predictive locations at dome, posterior wall, and trigone of bladder. It may also coexist or associate with cutaneous hemangioma including Sturge-Weber syndrome, or Klippel-Trenaunay-Weber syndrome. Management strategies are available. Observation, transurethral resection, electrocoagulation, radiation, systemic steroids, injection of sclerosing agent, and partial or complete cystectomy show adequate control. Although bladder hemangioma have a benign course, follow up is important to detect recurrence or residual disease.