膀胱内転移を伴った尿膜管癌

A CASE OF URACHAL CARCINOMA WITH INTRAVESICAL METASTASIS

　Stage Ⅲ Aの尿膜管癌に広範囲切除術を施行，後療法なしに術後30ヵ月間再発を認めない．本症例は摘出標本のマッピングで膀胱頂部のムチン産生中等度分化型腺癌とは別に，右尿管口上部の粘膜下に病理組織像が同一の非連続性病変を認めた．膀胱内転移は術前検査で発見不可能であり，臍・尿膜管全摘術＋膀胱部分切除術では根治性は得られない．自験例は根治的手術法として臍・尿膜管全摘術＋膀胱全摘出術の妥当性を確認した症例と考える．

A 35-year-old male with urachal carcinoma of the stage ⅢA type was treated in radical cystectomy with en bloc removal of the umbilicus. He has not been treated in any post operative therapy and to date, 30 months subsequent to the operation there has been no recurrence. Histologically, the tumor was moderately differential adenocarcinoma with mucous secretion. The same lesion was also found in the submucosa above the right ureteral orifice clarified through mapping of the resected bladder.