小児の尿道膀胱の尿路性乳頭腫。2例の報告

Urothelial Papilloma of the Urinary Bladder in Children: Report of Two Cases.

• Kata Davidovics
• Sandor Davidovics
• Andras Farkas
• Noemi Benedek
• Tamas Tornoczki
• Daniel Kardos
• Anna Davidovics
• Peter Vajda

抄録

膀胱の尿路新生物（UNB）は小児人口全体ではかなり稀である。膀胱尿道新生物は、良性疾患の形で尿道粘膜組織から発生し、大部分の症例では予後が良好である。尿路粘膜乳頭腫の診断と治療を行った2例の症例を紹介する。超音波検査と静脈内腎盂腎盂造影検査を含むルーチン検査の結果、尿道鏡検査で左尿管開口部付近に膀胱内孤発性の病変が認められた。さらに、組織学的に尿路粘膜乳頭腫を確認した。13歳の男性患者が当院に入院し、再発性腹痛を訴えて受診した。腹部US検査で偶発的に病変が発見された。術前のUS検査、MRI検査の結果、MRI検査を予定していたが、尿道鏡検査の結果、右尿管開口部付近に膀胱内単発性病変を確認し、組織検査では尿細管性尿道炎と診断された。組織学的には尿路乳頭腫が認められた。追跡管理下の膀胱鏡検査では、残留腫瘍の存在により1回の切除が繰り返された。尿路上皮性乳頭腫の存在から10年が経過した現在、両患者は無症状で腫瘍もない。再発の疑いがある場合は、膀胱鏡検査が推奨される。

Urothelial neoplasms of the bladder (UNB) are considerably rare throughout the pediatric population. UNB develops from the urothelial tissue in the form of a benign disease, generally favoring a successful prognosis in the majority of cases. The authors present the diagnosis and treatment regarding two medical case reports in which urothelial papilloma was diagnosed and effectively treated. : A 15-year-old male patient was presented to our clinic complaining of a painless yet distinctive, macroscopic form of hematuria. Following a routine examination, which included ultrasound (US) and intravenous pyelography, the urethrocystoscopy revealed an intravesical solitary lesion positioned in the vicinity of the left ureteral orifice. Additionally, histology confirmed urothelial papilloma. During the follow-up, laboratory, urinary control tests, and US results all proved negative. : A 13-year-old male patient was admitted to our clinic and examined, in regard to complaints associated with recurrent abdominal pain. The pathology was discovered incidentally on abdominal US. Preoperative US and magnetic resonance imaging (MRI) studies ensued, resulting in a scheduled MRI, followed by urethrocystoscopy, which confirmed an intravesical solitary lesion positioned near the right ureteral orifice. Histology revealed urothelial papilloma. During the follow-up control cystoscopy, one resection was repeated due to the presence of a residual tumor. Today, 10 years since the presence of uroepithelial papilloma, both patients are asymptomatic and tumor-free. If there is likely suspicion of recurrence, cystoscopy is recommended.