多発性骨転移を来したCEA,CA19-9産生膀胱移行上皮癌

A CASE OF CEA AND CA19-9 PRODUCTION BLADDER TUMOR WITH MULTIPLE BONE METASTASES

　67歳，男性。浸潤性膀胱腫瘍に対し動注化学療法後，膀胱部分切除術を施行。移行上皮癌，Grade 3,pT3b pNO MOであった。術後FAP療法（5-FU,THP-ADM,CDDP）を3コース施行，以後局所再発や遠隔転移を認めなかった。術後15か月目に後頸部痛と腰痛が出現し，骨シンチにて全身骨への異常集積像を認めた。血清CEA,CA19-9値の上昇がみられ，免疫組織学的検索にて膀胱の原発巣と骨転移巣がCEAとCA19-9で陽性に染色された。

A 67-year-old man underwent partial cystectomy and bilateral pelvic lymphadenectomy for invasive bladder tumor. Pathological diagnosis of the surgical specimen was TCC, Grade 3 and pT3b pNO MO. After 3 courses of FAP as adjuvant chemotherapy were performed, no regional recurrence and no metastases were confirmed. 15 months after the operation multiple bone metastases appeared. At this point the serum CEA and CA19-9 levels elevated. The cancer cells of surgical specimens and bone were stained positive for CEA and CA19-9.