膀胱平滑肌瘤诊疗分析

Diagnosis and treatment for leiomyoma of bladder

摘要:

目的  对膀胱非上皮性良性肿瘤中的平滑肌瘤的诊断和治疗进行回顾性研究，以便于更好地理解和掌握其诊断和治疗水平。方法  收集2007～2015年大连医科大学附属第二医院确诊为膀胱平滑肌瘤的患者10例，其中存在血尿表现的患者2例，存在尿频症状的患者1例，无明显临床症状因体检偶然发现的患者7例。行B超、CT等相关辅助检查，10例患者影像学提示膀胱内病灶生长。行膀胱镜检查，9例患者镜下可见膀胱内局部黏膜隆起，表面光滑、完整。1例患者镜下未提示明显异常。其中8例患者在全身麻醉下行膀胱肿瘤电切术，1例患者于全身麻醉下行膀胱镜检术+膀胱肿瘤剜除术，1例患者于全身麻醉下行膀胱镜检术+膀胱部分切除术。结果  10例病灶均完整切除，术后病例回报均确诊为膀胱平滑肌瘤。术后随访1～8年无一例复发。结论  在膀胱肿瘤中，膀胱平滑肌瘤的发病率较低，是较为少见的良性肿瘤，预后一般较好。目前对其术前诊断主要依靠影像学及膀胱镜检查，确诊则主要依靠病理学检查。通常情况下外科手术治疗可获得满意的效果。

Abstract:

Objective To retrospectively analyze the diagnosis and treatment of bladder leiomyoma cases so as to improve the diagnosis and treatment. Methods The data of 10 patients with bladder leiomyoma from 2007 to 2015 were analyzed retrospectively. There were 1 case with irritative bladder, 2 cases with hematuria and 7 cases without symptom. B-ultrasonography and CT were available in all 10 cases. Low-echo masses inside bladder were found in 10 cases at the first ultrasonographic examination. Cystoscopy showed local mucosal eminences with smooth surfaces in 9 cases and 1 case had no obvious abnormalities in cystoscopy. All the cases received operations. Among them, 1 case had tumor enucleation, 1 case was treated by partial bladder excision and 8 cases by transurethral resection of bladder. Results All the patients received partial cystectomy, and the tumors were successfully resected and pathologically diagnosed as bladder leiomyoma. The patients were followed up for 1 to 8 years without recurrence. Conclusions Leiomyoma of bladder is a rare benign tumor. Its diagnosis depends on B type uhrasonography, CT, cystoscopy and pathology. The definitive diagnosis is based on cystoscopy and pathological biopsy. Good prognosis can be achieved after radical resection of the tumor.