排尿障害を来した巨大膀胱内反性乳頭腫

Huge inverted papilloma of the bladder

　84歳男性．2009年排尿障害にて受診．近医で加療を受けていたが，2015年肉眼的血尿を認め当院紹介．膀胱鏡にて三角部に巨大な腫瘍性病変，MRIにて60mm大の腫瘍性病変を認め，膀胱癌cT1N0M0の診断にてTURBTを施行した．切除組織は内反性増殖を示し，腫瘍表層を尿路上皮が被覆，細胞異形に乏しく内反性乳頭腫と診断した．以降外来で膀胱鏡を行っているが再発は認めていない．内反性乳頭腫は30mm程度までの報告が大半を占め，60mmを超える報告例はない．

Abstract

A 84-year-old man with a complaint of dysuria in 2009 developed gross hematuria in 2015. At cystoscopy, there was a huge smooth-surfaced tumor at the trigone of bladder. He was diagnosed as non-muscle-invasive bladder tumor in the size of 60 mm and no metastasis by CT and MRI. We performed transurethral resection of the bladder tumor. Histological diagnosis was inverted papilloma. We followed up for 2 years, no recurrence occurred. There were many reports on inverted papilloma, however most of there were in the size of less than 30 mm. We report this case with some literature review (Rinsho Hinyokika 73 : 673-675, 2019).