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相關文獻
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題名 | 膀胱小細胞癌:二病例報告=Small Cell Carcinoma of Urinary Bladder: Report of Two Cases |
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作者姓名(中文) | 張俊毅; 呂清元; 鄭以弘; 陳宏恩; | 書刊名 | 臺灣家庭醫學雜誌 |
卷期 | 13:2 2003.06[民92.06] |
頁次 | 頁94-100 |
分類號 | 415.837 |
關鍵詞 | 膀胱; 小細胞癌; Small cell carcinoma; Urinary bladder; |
語文 | 中文(Chinese) |
中文摘要 | 膀胱小細胞癌是罕見且具高度侵襲性的腫瘤。我們於此報告兩例經尿道刮除術及全身性化學治療的膀胱小細胞癌,提醒基層醫師於病患因血尿而求診時,需注意罹患此病的可能性。 第一位是五十九歲男性,因持續一個月的無痛血尿及尿灼感而求診。靜脈腎盂攝影檢查發現有膀胱腫瘤。於經尿道切除腫瘤後,病理診斷為膀胱小細胞癌。因病患拒絕進一步手術而接受全身性化療及緩和性放射治療。於診斷後13個月,病患死於多處轉移及敗血症。 第二位是七十二歲男性,主訴為10天的無痛血尿及尿中血塊。影像檢查顯示有一巨大的骨盆腔腫塊附著於膀胱壁上,同時已有腹膜及肺的轉移。病患接受緩和性的經尿道刮除術,隨後因病理報告顯示為小細胞癌而接受全身性化學治療。病患於診斷後10個月死於多處轉移。 膀胱小細胞癌的臨床表現和其他膀胱的惡性腫瘤差異不大,最常見的臨床表徵是無痛血尿,接著有排尿困難和頻尿的現象。然而因其早期轉移的病程特性,大部分的病人在診斷出罹患此病時,已有局部的深度浸潤或轉移。雖然全身性化療合併手術或放射治療似乎是處理這類病患的準則,但因迄今發現之病例數有限,治療預後亦不佳,膀胱小細胞癌的最適當治療依然是一項艱難的課題。 |
英文摘要 | Small cell carcinoma of urinary bladder (SCCB) is an infrequent and highly aggressive tumor. We reported two cases of SCCB treated with TUR-BT and systemic chemotherapy. The first case was a 59-year-old male with complaints of painless gross hematuria and burning urination for 1 month. Bladder tumor was noted after IVP. After transurethral resection, small cell carcinoma of the urinary bladder was diagnosed. The patient refused major operation and received further systemic chemotherapy and palliative radiotherapy. He died of multiple metastasis and sepsis at about 13 months after diagnosis. The second case was a 72-year-old male with complaints of painless gross hematuria and blood clots retention for 10 days. Serial image studies revealed a huge pelvic mass adhesive to the urinary bladder, peritoneal carcinomatosis, and metastases of lung. The patient received palliative TUR-BT and subsequently received systemic chemotherapy, due to small cell carcinoma confirmed by pathological report. The patient died of carcinomatosis 10 months after diagnosis. The clinical presentations of SCCB do not differ from that of other malignant bladder tumors. The most frequent one is painless gross hematuria followed by dysuria and frequency. With the characteristic of early metastatic spreading, most patients presented with locally advanced or metastatic disease at the time of diagnosis. Systemic chemotherapy, in combination with surgery or radiation therapy, appears to be the most important component of management. But due to the limited number of cases and poor prognosis of the disease, the optimal treatment for SCCB has still been a difficult task. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。