内反性乳頭腫と移行上皮癌の膀胱内発生の2例

Inverted papilloma and papillary transitional cell carcinoma of the bladder：two case reports

症例1：患者は70歳，男性で，頻尿および肉眼的血尿を認め，当院を受診した。膀胱鏡検査では，左尿管口近傍と左側壁に乳頭状で広基性の腫瘍を認めた。Cisplatinおよびepirubicin動注後にTURBTを施行し，病理診断は内反性乳頭腫に発生した移行上皮癌であった。2年6か月後に後壁に膀胱腫瘍の再発を認めたため，TURBTを施行した。病理診断は移行上皮癌であった。症例2：患者は81歳，男性で，頻尿および排尿困難を認め，当院を受診した。膀胱鏡検査では，三角部に表面平滑な有茎性の腫瘍を認め，頂部には乳頭状で広基性の腫瘍を認めた。TURBTを施行し，三角部は内反性乳頭腫で，頂部は移行上皮癌との病理診断であった。内反性乳頭腫は再発や悪性化の可能性もあり，定期的な経過観察が必要と思われる。

Case 1. A 70-year-old man with difficult voiding and gross hematuria revealed to have a papillary pedunculated tumor adjacent to left ureteral orifice and at the left lateral wall. We performed the transurethral resection of the bladder tumor after intraarterial injection of cisplatin and epirubicin. The histological examination demonstrated transitional cell carcinoma arisen in inverted papilloma. Cystoscopic examination performed 2 years and 6months after the operation showed a recurrent tumor at the posterior wall. The histological examination of the recurrent tumor was transitional cell carcinoma. Case 2. An 81-year-old man with difficult voiding and pollakisuria revealed to have a smooth-surfaced,broad-based tumor at the trigone and a papillary pedunculated tumor at the dome. Transurethral resection of the bladder tumor was done and the tumor at the trigone was the inverted papilloma and one at the dome was transitional cell carcinoma. The inverted papilloma is generally thought to be a benign tumor,but there is a possibility of recurrence or development of transitional cell carcinoma,therefore,we think periodical cystoscopic follow-up examinations is mandatory.