尿路上皮癌的一例报告及文献复习

A Case Report and Literature Review of Urothelial Carcinoma

摘要: 背景：众所周知，转移性膀胱癌是膀胱癌的晚期表现。临床上一般认为其转移主要通过淋巴管或血液循环进行，但直接浸润直肠并有直肠环形收缩表现的病例却较为少见。病例介绍：本文报告了1例67岁男性，无明显诱因出现大便梗阻，小便失禁，行肠镜下取组织活检，病理提示转移性尿路上皮癌可能性大，在我科进行膀胱镜检查 + 膀胱肿瘤活检术，术后病理示高级别浸润性尿路上皮癌，后通过腹腔镜下输尿管皮肤造口术及结肠造口术成功进行手术治疗。结论：晚期转移性膀胱癌的诊断至关重要，患者的初始症状并不一定与泌尿系统相关。充分的辅助检查对明确诊断以及制定完善的诊疗方案具有很大的帮助。

Abstract: Background: It is well known that metastatic bladder cancer represents an advanced stage of the disease. Clinically, metastasis is generally considered to occur via lymphatic or hematogenous dissemination; however, cases demonstrating direct rectal invasion with annular rectal stricture are relatively rare. Case Presentation: This article reports a 67-year-old male who developed bowel obstruction and urinary incontinence without obvious predisposing factors. Colonoscopic biopsy suggested a high probability of metastatic urothelial carcinoma. Subsequent cystoscopy with bladder tumor biopsy in our department revealed high-grade invasive urothelial carcinoma on pathological examination. The patient successfully underwent laparoscopic ureterocutaneostomy and colostomy. Conclusion: Timely diagnosis of advanced metastatic bladder cancer is critical, as initial symptoms may not be urologically specific. Comprehensive auxiliary examinations are essential for accurate diagnosis and multidisciplinary treatment planning.