ぼうこう壁へ陥入したＳ状結腸憩室近傍から発生した高分化腺癌の１例

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  • A Case of Well-differentiated Adenocarcinoma Arising Adjacent to a Diverticulum of the Sigmoid Colon and Invading into the Urinary Bladder

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A 45-year-old man was admitted to the urology department of our hospital due to hematuria. Trans-urethral resection of a bladder tumor was performed. The pathological diagnosis was well-differentiated adenocarcinoma of the urinary bladder. Further examination including barium enema, colonoscopy, and computed tomography (CT) revealed a tumor of the sigmoid colon. Based on a diagnosis of the sigmoid colon cancer invading into the urinary bladder wall, we performed a sigmoidectomy and a partial resection of the urinary bladder. Postoperative pathological findings revealed that the adenocarcinoma of the urinary bladder was distinct the sigmoid colon cancer. The sigmold colon cancer did not invade beyond the musclaris propria of the colon wall. Further microscopic examinations disclosed a diverticulum of the sigmoid colon that extended into the urinary bladder wall, and a well-differentiated adenocarcinoma in the muscle layer of the bladder was blocked by the bottom of the diverticulum. In addition intestinal colonic metaplasia was not apparent in the urinary bladder mucosa adjacent to the tumor. This phenomenon suggested that the adeno-carcinoma of the bladder wall was possibly caused by chronic inflammatory stimulation of the colonic diverticulum.

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