Ein äußerst seltener Fall von multiplen Rezidiven eines Urothelzellkarzinoms in einer ilealen Neoblase: Fallbericht und Literaturübersicht

Zusammenfassung

In bis zu 18% tritt nach kurativer radikaler Zystektomie wegen eines Urothelkarzinoms ein Rezidiv auf. Zumeist manifestieren sich die Rezidive in den regionären Lymphknoten oder im verbliebenen oberen oder unteren Harntrakt. Extrem selten tritt ein Rezidiv in einer Neoblase auf, zumal es sich um ein anderes embryonales Keimblatt handelt.
Wir berichten über einen Fall, bei dem 10 Jahre nach der Zystoprostatektomie multiple Urothelkarzinomrezidive nur in der Neoblase auftraten. Daraufhin wurde die Neoblase entfernt und ein Sigma-Conduit angelegt. Trotzdem trat 6 Monate später eine generalisierte Metastasierung auf, woran der Patient wenig später verstarb. Zurzeit gibt es aufgrund der Seltenheit dieses Krankheitsbilds keine Behandlungsrichtlinien. Wir schildern unsere Erfahrungen und geben eine Literaturübersicht.

Abstract

In up to 18% of patients, recurrence is observed after curative radical cystectomy. Tumour recurrence occurs in most cases in the locoregional lymph node, as well as in the remaining urinary tract, but very rarely in the orthotopic neobladder.

We report a case of multiple recurrence of urothelial carcinoma solely in the orthotopic neobladder of a male patient, 10 years after surgery, without involvement of the urethra or upper urinary tract. Therefore, the patient underwent resection of the neobladder with conversion to a sigmoid conduit. Nevertheless approximately 6 months later the patient developed widespread metastases and died a few months later.

Currently, no guidelines are available for the treatment of these rare cases.

We present our experience, together with revision of the current literature on this issue.

Schlüsselwörter

Urothelzellkarzinom - Rezidiv - Neoblase - transurethrale Resektion - Metastasen

Keywords

transitional cell carcinoma - recurrence - neobladder - transurethral resection - secondary malignancy

• Literatur

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