特異な臨床経過を呈した膀胱癌

A Case of Bladder Cancer with Unusual Clinical Course

　症例は51歳の男性。不明熱と肉眼的血尿を主訴に来院した。膀胱鏡検査にて，膀胱三角部から右尿管口に非乳頭状広基性の腫瘍を認め，病理組織学的に低分化癌と診断した。血液検査上，感染症を疑い，各種抗生剤投与を行ったが反応しなかった。骨髄穿刺にて腫瘍細胞を認め，膀胱癌の骨髄転移と診断した。化学療法を施行したところ，一時的に著明な解熱傾向と血液検査の改善を認めるものの，病勢は抑えられなかった。

A 51-year-old male visited us with chief complaints of gross hematuria and pyrexia. Cystoscopy revealed a non-papillary and wide-based tumor between trigone and right ureteral orifice. The pathological diagnosis was the undif-ferentiated carcinoma. Several antibiotics were given with no response to high fever. Biopsy of bone marrow revealed a lot of tumor cells leading the diagnois of bone marrow metastasis from bladder cancer. Systemic chemotherapy was temporally very effective for high fever but not effec-tive for general conditions and he died of multiple organ failure 3 months after chemotherapy.