膀胱原発性小細胞癌の1例

SMALL CELL CARCINOMA OF THE URINARY BLADDER: A CASE REPORT

　69歳，男性。肉眼的血尿を主訴に受診。膀胱前壁に広基性非乳頭腫瘍を認め，膀胱全摘除術を施行。病理組織所見にて神経分泌顆粒を有するpT3bの小細胞癌と判断した。術後，骨盤腔内に54Gyのコバルト照射を施行。血清neuron-specific enolase（NSE）は，術前46ng／mlと高値を示したが術後6.5ng／mlと正常化した。術後5か月半，全身リンパ節転移にて死亡。血清NSEは140ng／mlであった。血清NSEが，再発の指標となった。

The patient was a 69 years old male who came to us with a primary complaint of gross hematuria. A wide-based non-papillary tumor was noted in the anterior wall of the bladder. Total cystectomy was carried out, and a diagnosis of pT3b small cell carcinoma having neurosecretory granules was made by histopath-ological examination. Postoperatively, we performed pelvic cobalt irradiation of 54 Gy. The serum NSE was increased preoperativery at 46 ng/ml, but became normalized to 6.5 ng/ml postoperatively. The patient died with generalized lymph node metastases five and a half months after operation, when the serum NSE was 142 ng/ml.