儿童膀胱假肉瘤性肌纤维母细胞增生1例报告并文献复习

吴新华; 韩晓敏; 石明; 刘述成; 陈敏

儿童膀胱假肉瘤性肌纤维母细胞增生1例报告并文献复习

- 华中科技大学同济医学院附属协和医院泌尿外科(武汉, 430022)

详细信息

通讯作者: 陈敏,E-mail:tjmchen@163.com

中图分类号: R730.269

收稿日期: 2011-03-27

Pseudosarcomatous myofibroblastic proliferation of urinary bladder in a child: A case report and review of the literature

- Department of Urology, Union Hospital, Huazhong University of Science and Technology, Wuhan, 430022, China

More Information

Corresponding author: CHEN Min, E-mail: tjmchen@163.com

Received Date: 27 March 2011

摘要

摘要: 目的：提高对儿童膀胱假肉瘤性肌纤维母细胞增生的诊疗水平。方法：报告1例儿童膀胱假肉瘤性肌纤维母细胞增生病例并结合文献复习，对本病的临床表现、病理特点、治疗及预后进行讨论。患儿，女，12岁，3年前因发现膀胱占位性病变并双肾积水肾功能不全在我院其他科室就诊。因其一般情况差，肾功能不全，行双肾穿刺造瘘术后出院。3年后再次来我院治疗。结果：行手术探查发现膀胱三角区实性息肉状肿物，大小4.4 cm×3.5 cm，膀胱两侧壁和顶壁可触及多个壁内结节，双侧输尿管口受压变形；切除三角区肿块送病检，结果示膀胱假肉瘤性肌纤维母细胞增生。行膀胱腔内结节切除加侧输尿管膀胱再植术。术后2个月拔双肾造瘘管，患儿自行排尿。术后6个月复查B超膀胱右侧壁仍可见结节，但无剩余尿及肾积水。结论：膀胱假肉瘤性肌纤维母细胞增生为一种良性增生性病变，临床上易误诊，可通过病理检查确诊，多采用手术切除肿瘤治疗，预后较好。
- 炎性假瘤 /
- 膀胱 /
- 儿童
Abstract: Objective: To improve the diagnosis and therapy of the pseudosarcomatous myofibroblastic proliferations of urinary bladder in children.Method: To report a case of pseudosarcomatous myofibroblastic lesion of the urinary bladder and discuss the clinical presentation, pathological features, treatment and prognosis of the disease. A 12-year-old female was found a bladder neoplasm with bilateral hydronephrosis and renal failure before 3 years. Bilateral percutaneous nephrostomy were made then the patient was discharged. There years later, she returns to our hospital in order to further treatment.Result: The surgical exploration revealed a broad-based polypoid mass (4.4 cm×3.5 cm) located in the trigone area of bladder and bilateral ureteral orifices were narrow. A fast evaluation of intraoperative biopsy for the mass confirmed the pseudosarcomatous myofibroblastic proliferation of urinary bladder. The patient subsequently underwent the bilateral replantation of ureter into bladder. Two months later the bilateral renal fistula tubes were removed and the patient micturate smoothly. Six moth later USG showed nodules were still visible in the right posterolateral wall of the bladder but there is no residual urine and hydronephrosis.Conclusion: Pseudosarcomatous myofibroblastic proliferation of urinary bladder is a benign proliferative lesion and detailed pathological examination could bring a definitely diagnosis. Surgical excision of the bladder lesion is suitable and the disease tends to have a relatively favourable prognosis.
- inflammatory psendotumor /
- urinary bladder /
- child

HTML全文

参考文献(9)

[1]	KOVACH S J,FISCHER A C,KATZMAN P J,et al. Inflammatory myofibroblastic tumors[J]. J Surg Oncol,2006,94:385-391.
[2]	HARIK L R,MERINO C,COINDRE J M,et al. Pseudosarcomatous myofibroblastic proliferations of the bladder:a clinicopathologic study of 42 cases[J].Am J Surg Pathol,2006,30:787-794.
[3]	SCHNEIDER G,AHLHELM F,ALTMEYER K,et al.Rare pseudotumors of the urinary bladder in childhood[J].Eur Radiol,2001,11:1024-1029.
[4]	HOJO H,NEWTON WA JR,HAMOUDI A B,et al.Pseudosarcomatous myofibroblastic tumor of the urinary bladder in children:a study of 11 cases with review of the literature.An Intergroup Rhabdomyosarcoma Study[J].Am J Surg Pathol,1995,19:1224-1236.
[5]	COFFIN C M,WATTERSON J,PRIEST J R,et al.Extrapulmonary inflammatory myofibroblastic tumor(inflammatory pseudotumor).A clinicopathologic and immunohistochemical study of 84 cases[J].Am J Surg Pathol,1995,19:859-872.
[6]	SHANKS J H,ICZKOWSKI K A.Spindle cell lesions of the bladder and urinary tract.Histopathology[J].2009,55:491-504.
[7]	ASANUMA H,NAKAI H,SHISHIDO S,et al.Inflammatory pseudotumor of the bladder in neonates[J].Int J Urol,2000,7:421-424.
[8]	HOUBEN C H,CHAN A,LEE K H,et al.Inflammatory myofibroblastic tumor of the bladder in children:what can be expected[J]? Pediatr Surg Int,2007,23:815-819.
[9]	HARIK L R,MERINO C,COINDRE J M,et al.Pseudosarcomatous myofibroblastic proliferations of the bladder:a clinicopathologic study of 42 cases[J].Am J Surg Pathol,2006,30:787-794.