骨盤腔内後腹膜に発生した巨大な神経鞘腫の1例 A CASE OF GIANT SCHWANNOMA OF THE INTRAPELVIC RETROPERITONEUM
症例は34歳,男性.腹痛,下痢を主訴に近医を受診し腹部腫瘤を指摘され,平成12年2月1日,当院紹介となる.超音波検査, CT, MRI,血管造影にて骨盤腔内の後腹膜腫瘍が指摘され, 3月28日手術施行した.腫瘍は巨大で骨盤腔内のほぼ全体を占め,経腹的アプローチ法にて腫瘍を摘出した.摘出腫瘍は, 12×15×9cm, 1,100gの黄白色の被膜を有する弾性軟な腫瘍であった.組織学的には紡錘型の腫瘍細胞が棚状・波状に配列しており,核異型は強くなく核分裂像は認めなかった.免疫組織学的にはS-100蛋白, Vimentin, NSEが陽性でAntoni A型とB型が混在する良性神経鞘腫と診断した.術後経過は良好で,第14病日退院となった.術後18カ月経過した現在再発は認めていない.
A 34-year-old man was referred to the hospital for an abdominal tumor, which was detected at another hospital when he visited there because of abdominal pain and diarrhea, on February 1, 2000. A retroperitoneal tumor in the pelvis was revealed by abdominal ultrasonography, CT, magnetic resonance imaging, and angiography. The patient underwent a surgical operation on March 28. The huge tumor was found to fill the almost entire pelvic cavity. It was removed by a transabdominal method. The extirpated tumor was 12×15×9cm in size, 1100g in weight and elastic soft. It had a yellowish white appearance and was well encapsulated on a cut section. It was histologically composed of spindle cells which were arranged in short bundles or interlacing fascicles. The tumor cells showed slight nuclear atypsim but no mitosis. Immunohistochemically, the tumor cells showed a positive stain for S-100 protein, Vimentin, and NSE. The definite diagnosis was benign schwannoma of Antoni type A and B. The postoperative course was uneventful. The patient was discharged from the hospital on 14th hospital day. There have been no signs of recurrence as of 18 months after the operation.
- 日本臨床外科学会雑誌 = The journal of the Japan Surgical Association
日本臨床外科学会雑誌 = The journal of the Japan Surgical Association 63(2), 480-484, 2002-02-25