経尿道的に切除した粘膜下型膀胱平滑筋腫

Submucosal-type leiomyoma of the urinary bladder treated by transurethral resection:A case report

症例は62歳，男性。右側腹部痛を訴え近医を受診し右尿管結石と膀胱腫瘍を指摘され当科に紹介された。膀胱右側に45mm大の隆起性病変を認め，膀胱鏡で粘膜下腫瘍を認めた。経尿道的に生検を行い平滑筋腫と診断された。腫瘍径から腫瘍核出術を考慮したが，患者の希望により，後日，経尿道的に可及的に切除した。視野制限によりすべて切除することは不可能であった。本邦において経尿道的切除術にて完全に切除された症例は13例で，平均最大径は17.8mmであった。

A 62-year-old man with the complaint of rigth flank pain,was referred to our hospital becase of the right ureter stone and bladder tumor 45mm in diameter,identified by DIP.Ultrasound examination,CT and MRI revealed a protruding tumor on the right-anterior wall.Cystoscopy showed a submucosal tumor covered with a normal mucosa.Histological diagnosis was leiomyoma of the urinary bladder by transurethral biopsy.We recommended open tumor excision considering tumor size,but further transurethral resection of the tumor was performed because consent of the patient was not obtained.Complete resection of the tumor was not possible due to the restriction of operative view.The average tumor size of 13 cases of complete resection of the tumor in Japan by transurethral resection was 17.8mm in diameter.