原発性女子尿道癌の2例  [in Japanese] TWO CASES OF PRIMARY FEMALE URETHRAL CANCER  [in Japanese]

我々は女子尿道癌の2例を経験したので報告する.症例1は尿閉,症例2は疼痛を伴う会陰部腫瘤を主訴としていた.両症例ともMRIで尿道腫瘍を認め,経会陰部生検で症例1は明細胞腺癌,症例2は扁平上皮癌と診断された.両症例とも尿道全摘(膣前壁合併切除)+膀胱ろう造設術を施行.症例1は術中に閉鎖リンパ節転移を認め,術後補助療法として放射線照射60Gyと5-fluorouracilとcisplatinによる化学療法の併用療法を施行したが,治療後6カ月で肺転移が出現している.術後20カ月で癌死した.症例2は術後5カ月で腫瘍マーカーの再上昇を認め,症例1と同じ併用療法を施行し,寛解が得られた,現在術後19カ月であるが,明らかな再発は認めていない.

Herein, we report two cases of female urethral cancer. Case 1 presented with acute urinary retention and case 2 presented with a painful perineal mass. Magnetic resonance imaging (MRI) revealed a urethral tumor in both cases. Histopathological examination of transperineal biopsy specimens from both patients suggested clear cell adenocarcinoma in case 1 and squamous cell carcinoma in case 2. Both cases underwent total urethrectomy with partial resection of the vaginal wall and cystostomy urinary diversion. With reference to case 1, obturator lymph node metastases were observed during surgery, and treatment comprised combined radiotherapy to 60 Gy and chemotherapy with 5-fluorouracil and cisplatin following surgery. However, metastases appeared in the lung 6 months after initial treatment and she died 20 months after surgery. For case 2, tumor marker failure was observed 5 months after surgery. The same combined treatment was performed and a complete response was obtained. At 19 months after surgery, the patient showed no evidence of recurrence.