ヒト絨毛性ゴナドトロピンが高値を示した膀胱腫瘍

CARCINOMA OF THE URINARY BLADDER WITH HCG SECRETION

　79歳，男性．無症候性肉眼的血尿を主訴に来院．膀胱腫瘍の診断で経尿道的膀胱腫瘍切除術を施行した．病理診断は未分化癌で，一部に絨毛癌様の部分が混在しており，術後の検索でも血清および尿中ヒト絨毛性ゴナドトロピン（HCG），ヒト絨毛性ゴナドトロピンβサブユニット（β—HCG）が高値であった．合併症のため膀胱全摘の適応なく，3ヵ月半後に死亡した．剖検では他の原発巣は認められず，本邦13例目の絨毛癌の要素をもつ膀胱腫瘍と考えられた．

We report a case of bladder cancer with an element of choriocarcinoma in 79-year-old male. His chief complaint was asymptomatic macrohematuria and a coin lesion was pointed out on chest X-ray. Bladder cancer was suspected and TURBT was performed. Pathologically, the diagnosis was undifferentiated carcinoma with an element of choriocarcinoma. Both HCG and β-HCG in serum and urine were extremely elevated yet postoperatively. Because of poor general condition, radical operation was not indicated, and after about 3 months he died of DIC and respiratory dysfunction.