[A case of hepatoid adenocarcinoma of the urinary bladder]

A 79-year-old man was admitted to our hospital with a chief complaint of pollakisuria. He was diagnosed as having bladder tumors and bladder stone by cystoscopy. Transurethral resection of bladder tumors (TURBT) and transurethral cystolithotripsy were performed and histology revealed non-muscle-invasive hepatoid adenocarcinoma that produced alpha-fetoprotein (AFP) and urothelial carcinoma. The serum AFP level was present at a high level of 39.08 ng/ml. After five months' follow up, recurrent tumor were detected in the bladder. TURBT was performed and the pathologic finding showed non-muscle-invasive (not hepatoid) adenocarcinoma that produced AFP. After eight months' follow up, a recurrent tumor was detected in the bladder again. TURBT was performed and the pathologic finding showed non-muscle-invasive urothelial carcinoma. However, the serum AFP level remained above 35 ng/ml. After the 3rd TURBT, intravesical intillations were performed, which led to a normalization of the serum AFP level. Nineteen months after his final hospitalization, the patient has had no evidence of recurrence.