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目的:探讨膀胱恶性嗜铬细胞瘤的临床诊断和治疗方法。方法:回顾性分析3例膀胱恶性嗜铬细胞瘤患者的临床资料,并结合相关文献综合分析讨论本病的临床特点、诊断和治疗方法。结果:3例患者起病均有排尿时一过性血压升高症状,B超、CT扫描和膀胱镜检查可见膀胱占位性病变。膀胱肿瘤TNM分期,3例患者分别为T2aN0M0、T2aN0M0、T2bN0M0;3例患者均行膀胱部分切除术,术后病理检查示膀胱恶性嗜铬细胞瘤。随访12～120个月,平均随访3年。1例随访6年后因肺部转移而死亡:2例于术后2、3年因广泛盆腔淋巴结浸润又行盆腔淋巴结清扫术,术后恢复顺利,随访无其他不适。结论:膀胱恶性嗜铬细胞瘤需经膀胱镜检查及术后病理确诊,TNM分期在Tis、T1、T2期的肿瘤行膀胱部分切除术,分期在T3期以上或位置在膀胱颈口附近,则行根治性膀胱全切除术+盆腔淋巴结清扫术。
Objective: To investigate the clinical diagnosis and treatment of malignant pheochromocytoma in bladder. Methods: The clinical data of 3 patients with malignant pheochromocytoma of the bladder were retrospectively analyzed. The clinical features, diagnosis and treatment of this disease were discussed in combination with related literatures. Results: All three patients had onset of transient hypotension during urination. B-scan, CT scan and cystoscopy showed bladder space-occupying lesions. TNM staging of bladder cancer, three patients were T2aN0M0, T2aN0M0, T2bN0M0; 3 patients underwent partial partial resection of the bladder, postoperative pathology showed malignant bladder pheochromocytoma. The patients were followed up for 12 to 120 months and followed up for an average of 3 years. One patient died of lung metastases after 6 years of follow-up. Two patients had pelvic lymphadenectomy due to extensive pelvic lymph node infiltration at 2 and 3 years after operation. The postoperative recovery was complete without any other discomfort. Conclusions: Bladder malignant pheochromocytoma needs to be confirmed by cystoscopy and postoperative pathology. TNM staging is performed in Tis, T1 and T2 tumors with partial or partial bladder resection at or above stage T3 of the bladder neck. Radical radical cystectomy + pelvic lymph node dissection.