Adenokarcinom urahusa – prikaz bolesnika i pregled literature
Sažetak
Uvod. Adenokarcinom urahusa je izuzetno redak i čini od 0.35% do 0.7% svih tumora mokraćne bešike. Najčešći histološki tip tumora urahusa je adenokarcinom, koji može biti udružen sa intestinalnom metaplazijom i produkcijom mucina. Prikaz bolesnika. Prikazujemo slučaj bolesnika starog 53 godine, koji je došao kod urologa zbog intermitentne hematurije koja se javljala u periodu od tri meseca. Na ultrazvučnom pregledu uočena je infiltracija mokraćne bešike uz fundus, dijametra oko 24 × 29 mm. Uz isti zid neposredno uz tumorsku promenu, bila je prisutna ovalna hipoehogena promena dijametra oko 40 mm. Nalaz kompjuterizovane tomografije pokazao je solidnu, ehogenu, jasno ograničenu tumefakciju na krovu mokraćne bešike, anteriorno, dijametra 32 × 35 × 22 mm koja se dobro prebojavala nakon aplikacije kontrastnog sredstva. Bolesniku je učinjena parcijalna cistektomija sa potpunom ekscizijom tumorske promene na 1,5 cm do u zdravo tkivo. Histopatološkom analizom postavljena je dijagnoza Adenocarcinoma mucinosum vesicae urinariae infiltrans. Na patohistološkom nalazu uočen je deo zida urahusa sa tankim slojem fibromuskularnog tkiva, hroničnim zapaljenjem u zidu, mikrokalcifikatima u lumenu, aplatiranim i najvećim delom deskvamovanim epitelom. Godinu dana nakon operacije nije bilo znakova recidiva tumora niti pojave metastaza u drugim organima. Zaključak. Adenokarcinom urahusa je izuzetno redak. Dugoročno preživljavanje se može postići hirurškim tretmanom u ranoj fazi bolesti, koji obuhvata kompletnu resekciju karcinoma urahusa i parcijalnu ili totalnu cistektomiju.
Reference
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