Gül TÜRKÇÜ, Ayşe Nur KELEŞ, Ulaş ALABALIK, Yaşar BOZKURT, HÜSEYİN BÜYÜKBAYRAM

Primer mesane yerleşimli koryokarsinom olgusu

Koryokarsinom sıklıkla kadınlarda uterusta ve overlerde, erkeklerde testiste gelişim gösteren kötü prognozlu bir tümördür. Primer mesane yerleşimli koryokarsinom ise oldukça nadir olarak görülmektedir. Solunum güçlüğü, öksürük, hematüri ve disüri şikayetleri ile hastaneye başvuran 28 yaşındaki erkek olgunun yapı- lan radyolojik incelemelerinde akciğerlerde metastaz ile uyumlu lezyonlar ve mesane ön duvarında lümen içine uzanım gösteren kitle tespit edildi. Olguya yapılan sistoskopik inceleme esnasında tümör dokusuna inkomplet transüretral rezeksiyon uygulandı. Tümör dokusunun histopatolojik incelemesinde polihedral iri mononükleer hücreler arasında sinsityotrofoblast ile uyumlu hücreler izlendi. Tümör dokusunda pansitokeratin, sitokeratin 7, yüksek molekül ağırlıklı sitokeratin, human plasental laktojen ve human koryonik gonadotropin ile boyanma izlenirken, epitelyal membran antijen, karsinoembriyonik antijen, CD30, p63 ve sitokeratin 20 ile boyanma görülmedi. Mevcut histopatolojik ve immünohistokimyasal bulgular koryokarsinom ile uyumlu olarak değerlendirildi. Olgunun nadir görülmesi, kötü prognozlu olup genellikle metastaz ile ölüme sebep olabilmesi ve yüksek dereceli ürotelyal karsinomların ayırıcı tanısında akılda bulundurulması gerekliliği nedeni ile literatür bilgileri eşliğinde sunulması amaçlanmıştır.

A case of Choriocarcinoma primarily located in the urinary bladder

Choriocarcinoma is a tumor with poor prognosis which usually develops in the uterus and ovaries in females and testes in males. Choriocarcinomas primarily located in the urinary bladder occur extremely rare. In the radiological examination of the 28 year old male patient presented with cough, difficulty in breathing, dysuria and hematuria; lung lesions compatible with metastasis and a mass which was extending inside of the lumen in the anterior wall of the urinary bladder were determined. During the cystoscopic investigation, an incomplete transurethral resection was applied to the tumor. In the histopathological evaluation of the tumor tissue, cells compatible with syncytiotrophoblasts were observed among the polyhedral large mononuclear cells. While positive staining with pancytokeratin, cytokeratin 7, high molecular weight cytokeratin, human plasental lactogen, and human corionic gonadotrophin was observed in the tumor tissue, there was not any staining with epithelial membrane antigen, carcinoembryonic antigen, CD30, p63, and cytokeratin 20. Present histopathological and immunohistochemical findings were evaluated as compatible with coriocarcinoma. Because of being seen rarely, having poor prognosis, causing death due to metastasis, the necessity of holding in mind in the differential diagnosis of high grade urothelial carcinomas, it is purposed to present the case accompanied by literature information.

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