筋層非浸潤性膀胱癌に対する経尿道的膀胱腫瘍切除術後7年目に多発肺転移をきたした1例

Multiple Pulmonary Metastases Seven Years After Transurethral Bladder Tumor Resection for Non-muscle Invasion Bladder Cancer：Report of a Case

はじめに　筋層非浸潤性膀胱癌は膀胱癌全体の約7割を占め，予後は比較的良好である．膀胱癌の転移先を検討した剖検例の報告では，肺は所属リンパ節，肝臓に次ぐ頻度であるが，筋層非浸潤性膀胱癌では肺を含めた遠隔転移はまれとされている．われわれは，筋層非浸潤性膀胱癌に対して経尿道的膀胱腫瘍切除術（TUR-Bt）後7年目に局所進展を伴わずに多発肺転移をきたした症例を経験したので，若干の文献的考察を加えて報告する．

A 64-year-old man was admitted because of multiple pulmonary nodules in right upper lobe on chest computed tomography （CT）. He had non-muscle invasion bladder cancer resected by transurethral bladder tumor resection seven years ago. Partial resections of the right upper lobe were carried out at the video assisted thracoscopic surgery （VATS） for diagnostic purposes. The postoperative pathological examination revealed featuraes of pulmonary metastasis of bladder cancer. Although chemotherapy after biopsy was performed, a residual tumor in right S3 has grown. Partial resection of residual tumor was carried out thracoscopically and the tumor was diagnosed as metastasis of bladder cancer. He has been without recurrence for 1 year after the operation.