大腸の神経節神経腫の1例

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タイトル別名
  • ダイチョウ ノ シンケイセツ シンケイ シュ ノ 1レイ
  • A Case of Colonic Ganglioneuroma

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We report a 50-year-old male patient referred to our hospital by a local physician because pathological diagnosis indicated a requirement for additional surgical excision after endoscopic mucosal resection for early-stage large-intestinal cancer and a torus lesion at the descending colon as a sub-lesion. Endoscopy of the large intestine revealed a scar at the sigmoid colon after endoscopic mucosal resection. The lesion at the descending colon was a gentle torus lesion measuring about 1/4 of the circumference of the colon with a shallow white smooth concave face, indicating a submucosal tumor. A diagnosis of ganglioneuroma was made by biopsy of the central concave face. Partial excision of the sigmoid colon and wedge excision of the descending colon tumor were performed by hand-assisted laparoscopic surgery. Examination of the excised specimens revealed no residual cancer in the scar of the sigmoid colon or its metastasis to lymph nodes. The lesion of the descending colon was positive for s-100 and neuron specific enalase on immunostaining. Thus, a definite diagnosis of ganglioneuroma was made in agreement with the diagnosis based on the biopsy before surgery. Ganglioneuroma occurring at the gastrointestinal tract besides with a single lesion, as in the present case, is a very rare disease and usually complicated with von Recklinghausen's disease or MEN Type 2b. This case is reported with some bibliographical considerations.

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