1982 Volume 73 Issue 8 Pages 1058-1062
A 36-year-old tripara woman in the fifteenth week of pregnancy was admitted to our hospital, because of gross hematuria. No vaginal bleeding was noticed. There were active fetal movements, and the fetal heart tones were strong. Routine blood chemistry studies were within normal limit. A severe hypochromic, microcytic anemia was present. Cytology of the urine showed the class IV. Cystoscopy revealed a huge tumor on the left side of the bladder wall. The biopsy specimen of the bladder tumor was grade I, transitional cell carcinoma.
The pregnancy was stopped by artificial abortion. The cystography demonstrated a large shadow defect on the left half of the bladder. The pelvic angiography revealed a rich-vasculized tumor. Preoperatively, arterial chemoembolization was done twice with microenccapsulated mitomycin C 10mg and 30mg. Gross hematuria diminished. Substantial tumor reduction of greater than 50 per cent was found cystographically. Total cystectomy with ileal conduit formation was performed. A hen's egg sized tumor and a red bean-sized tumor were found in the bladder. Histological examination revealed grade I, stage A, transitional cell carcinomas but did not demonstrated the remarkable effect of chemoembolization. The patient did well postoperatively and has been followed for 6 months without any evidence of metastasis or recurrence.
Primary non-bilharzial bladder carcinoma during pregnancy is extremely rare in the world literature. We add another ease, bringing the total number of reported cases to 8. The authours' case seemed to be the 1st in Japan. Our experience in the present case suggests that hematuria during pregnancy requires a through urologic diagnostic study as usual and that hysterectomy with total cystectomy should not necessarily be indicated in any bladder carcinoma in pregnancy.
