持続勃起症を呈した膀胱癌陰茎海綿体転移

Corpus spongiosum metastasis with malignant priapism due to multiple metastatic bladder carcinoma：A case report

患者は62歳，男性。初診時既に肺，後腹膜リンパ節に転移を認める膀胱癌で，経尿道的膀胱腫瘍切除後メソトレキサート＋塩酸エピルビシン＋シスプランチン併用療法（MEC療法）を開始した。2クール目を施行中に陰茎部痛と硬結を訴えた。陰茎は半勃起状態で疼痛を伴った。陰茎転移の疑いで陰茎海綿体生検および陰茎-尿道海綿体シャント術を施行したが疼痛は改善せず，その後急激な転帰をとった。病理結果は海綿体血管内にびまん性に移行上皮癌が広がる膀胱癌陰茎海綿体転移であった。

A 67-year-old man was diagnosed as transitional cell carcinoma（TCC）of the bladder,grade 3 and stage pT3 with metastasis to lung,para aortic and internal iliac lymph node. During treatments of combined chemotherapy,MEC regimen,he had painful semi-erect penis. We tried bloodletting suspecting priapism,but only in vain. Needle biopsy of the corpus spongiosum histologically revealed metastatic TCC. Regardless of additional MEC therapy,metastatic lesions progressed and brain metastasis developed,and he died in June 2004.