背景:原发性尿道癌极为罕见,导致临床医生的经验受到限制,而准确的诊断往往因非特异性临床表现而延迟。这里,我们提供此病例报告,以显示一名原发性尿道癌患者的治疗方法。我们的患者在宜昌市第一临床医院通过膀胱镜检查和活检被诊断为原发性尿道癌。由于她的年龄,身体耐受性差,和经济状况,她拒绝了激进的手术。由于临床上对原发性尿道癌的治疗过程没有明确的指导,不同医院的手术方法和术后辅助治疗各不相同,导致不同的预后效果。
方法:一名88岁的亚洲女性排尿困难超过6个月,症状加重1个月。她选择了较为守旧的医治计划:原发肿瘤切除联合膀胱灌注化疗。术后病理显示“尿道”高级别尿路上皮癌(肉瘤样变种)伴广泛坏死。用膀胱内化疗药物(羟基喜树碱40mg)治疗后,她最终从我们医院出院,情况稳定。术后随访观察该保守治疗方案在多大程度上改善了患者的生活质量和总体生存时间。
结论:根据实际情况需要进行根治性切除。然而,她的年龄限制了她对全身麻醉的耐受性;相对保守的治疗方案可确保高质量的生活.原发肿瘤切除联合膀胱灌注化疗的医治是可行的。该病例强调了传播新病例和优化原发性尿道癌诊断以获得有效治疗的重要性。
BACKGROUND: Primary urethral cancer is exceedingly rare, resulting in a limitation in clinicians\' experience, and an accurate diagnosis is often delayed due to the non-specific clinical presentation. Here, we present this
case report to show the treatment of a patient with primary urethral cancer. Our patient was diagnosed as having primary urethral cancer in the First Clinical Hospital of Yichang by cystoscopy and biopsy. Due to her age, poor physical tolerance, and economic condition, she refused radical operation. Since there is no definite guideline for the treatment process of primary urethral cancer in clinics, operation methods and postoperative adjuvant treatments vary in different hospitals, leading to diverse prognostic effects.
METHODS: An 88-year-old Asian woman had difficulty in urinating for more than 6 months and the syndrome was aggravated for 1 month. She chose a relatively conservative treatment plan: primary tumor resection combined with bladder perfusion chemotherapy. Postoperative pathology revealed \"urethra\" high-grade urothelial carcinoma (sarcoma-like variants) with extensive necrosis. After treatment with intravesical chemotherapeutic drug (hydroxycamptothecin 40 mg), she was eventually released from our hospital in a stable condition. Postoperation follow-up was performed to observe to what extent this conservative treatment plan improved the quality of life and overall survival time of our patient.
CONCLUSIONS: She needed radical resection according to the actual situation. However, her age restricted her tolerance to general anesthesia; relatively conservative treatment options are available to ensure a high quality of life. The treatment of primary tumor resection combined with bladder perfusion chemotherapy is feasible. This
case highlights the importance of the dissemination of new cases and optimizing primary urethral cancer diagnosis to obtain an effective treatment.