膀胱の悪性中胚葉性混合腫瘍

A CASE OF MALIGNANT MESODERMAL MIXED TUMOR OF THE BLADDER.

　74歳，女性。肉眼的血尿にて来院。拇指頭大，有茎性の膀胱腫瘍が発見され，TURを施行した。組織学的には，腫瘍の大部分は紡錘形細胞より成り，筋層内へ浸潤していた。移行上皮癌と腺癌が島状に存在しており，一部軟骨組織もみられた。免疫組織化学的染色により，上皮性成分と非上皮性成分の存在が明らかで，悪性中胚葉性混合腫瘍と診断した。後に膀胱全摘出術，回腸導管形成術を施行し，化学療法（CAP）2コース行い経過観察中である。

A 74-year-old woman who complained of gross hematuria had transurethral resection of a bladder tumor. Pathologic examination showed numerous spindle cell proliferation interspersed among transitional cell carcinoma and adenocarcinoma. This sarcomatous component was myxoedematous highly invasive into the bladder muscle and had the element of cartilage. Immunohistochemical studies revealed that this tumor was composed of element of carcinoma and of sarcoma. The histogenesis of malignant mesodermal mixed tumor of the bladder was also discussed.