- 期刊
Inverted Urothelial Papilloma of the Urinary Tract: Analysis of 11 Cases
病例分析：泌尿上皮倒生性乳頭瘤
摘要
研究目的：本研究報告本科泌尿上皮倒生性乳頭瘤的臨床經驗，並且討論此一罕見良性泌尿上皮病灶的治療方式及臨床意義。 材料與方法：從1990年至2002年，總共11位病患在本院經病理科診九為泌尿上皮倒生性乳頭瘤，我們對這十一位病患的統計資料、表現症狀、診斷及治療，做一回顧與分析。 結果：這十一位病患中，男性佔九位，腫瘤的位置有六個在膀胱頸、二個在膀胱三角、二個在膀胱後側壁、一個在下段輸尿管；並沒有多發性病灶。病人最常見的表現症狀為血尿及排尿困難。三位病患曾接受靜脈腎盂攝影檢查，只有一位的X光片可見充盈缺損；四位病患曾接受經直腸超音波檢查，其中兩位的膀胱超音波影像可見到異質性腫塊。正確診斷需要直視下切片。膀胱的病灶全部採經尿道膀胱腫瘤切除方式處理。有一位病患腫瘤位置在下段輸尿管，則施以輸尿管部分切除手術處理。巨觀下，大部分的病灶被描述成息肉狀，病灶從2公厘到23公厘。病人術後平均追蹤時間是五十一個月，在追蹤期間都沒有腫瘤復發或膀胱上皮癌的發生。 結論：泌尿上皮倒生性乳頭瘤為一罕見的良性腫瘤，病患以男性居多。術前確切診斷常有困難。對上泌尿道之此種腫瘤，經由術前內視鏡切片或術中冷陳切片得到病理診斷，可避免採行根除性手術的治療方式。
並列摘要
OBJECTIVE: We report on 11 cases of inverted urothelial papilloma and discuss the management and significance of this rare benign urothelil lesion. MATERIALS AND METHODS: From 1990 to 2002, eleven patients were pathologically documented as having inverted urothelial papilloma in our institute. Their demographic data, presenting symptoms, diagnoses, and treatments were retrospectively reviewed. RESULTS: Of the 11 patients, 2 were women (18%). The mean age at presentation was 62 years. he tumor was located in the bladder neck (6 cases), tigone (2 cases), posterior and lateral wall (2 cases), and lower ureter (1 cases). No patient had multiple lesions. The most common presentations were hematuria and obstructive complaints. a filling defect was noted in only 1 of 3 patients who had excretory urograms, and a discrete heterogeneous mass was seen in 2 (50%) of 4 patients who received transrectall ultrasonography. Diagnosis required direct visualization and biopsy. Lesions in the bladder were all resected transurehrally. One patient with a lesion in the lower ureter was treated by segmental ureteral resection. most lesions (7 of 11) were macroscopically described s polypoid lesions, with a diameter of 2 to 23 mm. no patient had recurrence or subsequent development of urothelial carcinoma after a mean follow-up of 51 (range, 1-144) months. CONCLUSIONS: Inverted urothelial papillomas are rare benign lesions with a male predominance. a definite preoperative diagnosis is difficult. For tumors in the upper tract, pathologic diagnosis based on endoscopic biopsy or intraoperative frozen section may obviate the need for radical surgery.