原发膀胱小细胞癌1例报告并文献分析

目的：报告原发膀胱小细胞癌1例并研究其诊治方法。方法：回顾性分析1例患者的临床和病理资料并结合文献复习讨论。结果：患者以无痛性全程血尿就诊,发现膀胱右侧壁肿块,病检为小细胞癌,免疫组化示神经内分泌标记物Syn、CoA、NSE阳性,行TURBt两月后复发,随即行膀胱全切回肠新膀胱原位排尿术,随访1年无复发和转移。结论：此病少见,恶性程度高,尽管其临床特征同移行细胞癌相同,但治疗方案并无统一意见,治疗需多种手段共同干预,包括手术和放、化疗。

On Primary Small Cell Carcinoma of the Bladder

Objective: To report a case of primary small cell carcinoma(SCC) of the bladder and study the diagnosis and treatment.Methods:A retrospective study on clinical and pathological data of a patient with primary small cell carcinoma of the bladder,and a review of the literature on this topic were presented.Results: The outstanding symptom of the case was hematuria.A tumor was located in the right wall of the bladder.On histopathological study,the tumor was characterized by small cell carcinoma,immunohistochemical assay of Syn,EMA and NSE being positive in the tumor tissues.The case underwent TURBt with adjuvant chemotherapy,and there was a small tumor recurrence after 2 months.The case underwent total cystectomy and an ileal orthotopic neo-bladder procedure.After 1 year,there was no evidence for recurrence and metastases.Conclusion: SCC of the urinary bladder is rare,highly aggressive neoplasm,though the clinical and epidemiological characteristics have some similarities with transitional cell carcinoma.Its therapy advice is not yet uniform and its treatment should be multidisciplinary,including surgery,chemotherapy and radiotherapy.