直腸Ｏｌｅｏｇｒａｎｕｌｏｍａの１例

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  • A Case of a Rectal Oleogranuloma

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A case of a rectal oleogranuloma (OG) caused by long-term use of ointment for hemorrhoids is reported. A 64-year-old man, who had undergone the Whitehead-operation 15 years previously, but had not received any injection treatment for hemorrhoids, was introduced to my clinic because of difficulty in passing stools in October 2001. Prior to the first consultation, he had used an ointment once a day for 21 months because of prolapse and bleeding of his hemorrhoids. He had experienced pain in using the ointment and difficulty in passing stools since September 2001. Digital examination showed a 3-cm elastic submucosal tumor in the left anterior wall and a prolapsed hemorrhoid in the opposite site of the anus. A semiclosed hemorrhoidectomy was performed, and rectal biopsies of the tumor were taken. The histological findings of the tumor specimens showed an oleogranuloma, and so use of the ointment was stopped without any further resection of the mass. Postoperative computed tomography taken two months later showed that the tumor had shrunk markedly, and his symptoms improved. At a recent consultation in October 2004, digital examination revealed that the mass had reached a size of less than 1cm in diameter, and the patient was symptom-free. To our knowledge, eight cases of rectal OG caused by suppository and/or ointment have been reported. We discuss the site and the size of 25 cases of rectal OG., including the above-mentioned eight cases.

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