後腹膜原発の粘液性嚢胞腺癌の1例  [in Japanese] A CASE OF RETROPERITONEAL MUCINOUS CYSTADENOCARCINOMA  [in Japanese]

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Author(s)

    • 松野 直徒 MATSUNO Naoto
    • 東京医科大学八王子医療センター外科学第5講座 Fifth Department of Surgery, Hachioji Medical Center of Tokyo Medical University
    • 内山 正美 UCHIYAMA Masami
    • 東京医科大学八王子医療センター外科学第5講座 Fifth Department of Surgery, Hachioji Medical Center of Tokyo Medical University
    • 長尾 桓 NAGAO Takeshi
    • 東京医科大学八王子医療センター外科学第5講座 Fifth Department of Surgery, Hachioji Medical Center of Tokyo Medical University

Abstract

後腹膜原発の嚢胞腺癌は極めて稀な症患である.今回われわれは後腹膜原発性粘液性嚢胞腺癌を経験したので報告し,同時に本邦報告例23例について文献的考察を加えた.症例は39歳女性,主訴は腹痛.左側腹部に無痛性の腫瘤が触知され,腹部CT, 腹部超音波検査にて大きさ20cm×18cm×15cmの嚢胞腫瘤とその内腔へ突出した直径2.0cm大の乳頭状嚢胞内腫瘤を認めた.腹部血管造影で左下腹部の血管に圧排所見を認めた.注腸にては圧排所見のみで異常所見を認めなかった.開腹所見では下行結腸の後外側方に位置した巨大腫瘤が結腸を壁外性に圧迫していた.摘出した後腹膜腫瘍は嚢胞性腫瘤で内腔に突出する乳頭状腫瘤を認め病理組織学的には粘液性嚢胞腺癌と診断された.嚢胞液中および免疫組織学的検討で嚢胞壁のCA 19-9が陽性であった.術後約2年の現在,再発の兆しもなく生存中である.他臓器の異常所見もなく後腹膜原発の腫瘤と考えられた.

The great majority of tumors arising in the retroperitoneum are non-epithelial tumor. Primary retroperitoneal mucinous cystadenocarcinoma is very rare. We present such a rare case with some notes on 23 cases reported in the Japanese literature. A 39-year-old woman was admitted to the hospital because of distention and tenderness of the right lower quadrant of the abdomen.<br> Abdominal imagings revealed a giant cystic mass 20×18×15cm in size and an intracystic tumor 2cm in diameter. Abdominal angiography revealed displacement of the left lower abdominal vessel. Barium enema study showed no abnormal findings other than oppression image. At laparotomy, a large cystic tumor was found in the leftlateral abdominal region which showed extramural pressure to the colon. Macroscopic photograph of resected specimen showed simple large cyst with protruding papillary tumor inside of the cyst and the inner space was filled with mucinous fluid. Histologically, it was mucinous cystadenocarcinoma. The mucinous fluid and cystic wall were CA19-9 positive on immunohistochemical studies.<br> The Patients is living and has been free from recurrence for 2 years after the operation. Since no abnormalities in other organs have been seen, we think that the tumor was primary retroperitoneal mucinous cystadenocarcinoma.

Journal

  • Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)

    Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 62(2), 542-545, 2001-02-25

    Japan Surgical Association

References:  16

Cited by:  3

Codes

  • NII Article ID (NAID)
    10008388557
  • NII NACSIS-CAT ID (NCID)
    AA11189709
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    13452843
  • Data Source
    CJP  CJPref  J-STAGE 
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