成人仙骨部類表皮嚢胞の1例  [in Japanese] A CASE OF ADULT PRESACRAL EPIDERMOID CYST  [in Japanese]

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Abstract

症例は50歳,女性.平成5年10月,発熱,下腹部痛を認め,産婦人科にて後腹膜膿瘍の診断のもと開腹下に切開排膿ドレナージ術を施行.平成8年5月,同様の所見を認め, 9月25日,当科受診.直腸指診にて,直腸の右側後方に表面平滑,可動性不良で,柔らかい腫瘤を触知した.画像診断で仙骨前面に約10cm大の嚢胞を認めた.穿刺吸引細胞診にて扁平上皮を認め,奇形腫疑いのもと,経仙骨的に腫瘍を摘出した.組織学的に,嚢胞壁内面は角化した重層扁平上皮からなり一部に粘液産生円柱上皮を認めた.皮脂腺や毛嚢等の皮膚付属器を認めず類表皮嚢胞と診断した.<br> 成人の仙骨前下類表皮細胞の本邦報告例は8例で,全例女性であった.痛みや下血を訴える例もあるが,症状がなく検診等で発見された例が6例であった.手術は5例に経仙骨的切除術が施行された.

A case of presacral epidermoid cyst successfully resected via sacral approach in a 50-year-old woman is reported.<br> The patient was seen at the hospital because of lower abdominal pain in May, 1996. The previous medical history revealed that she underwent laparotomy and drainage for retropelvic abscess at elsewhere in October, 1993, when she also complained of fever and lower abdominal pain. After admission a smooth, soft and unmovable tumor was palpatd right behind the rectum by digital examination.<br> CT, MRI and ultrasonographic examination showed a presacral cystic tumor, 12×10×8cm in size. Aspiration biopsy cytology of the tumor showed squamous cells, suggesting presarcal teratoma. The tumor was resected by using a sacral approach with Jack-knife position. Histologically, the inside of the cyst wall consisted of keratinizd squamous epithelium nd in part mucin producing columnal epithelium. No sebaceus gland and hair was found. The cyst was diagnosed as epidermoid cyst.<br> In a review of Japanese literature, eight cases of adult presacral epidermoid cyst were seen. All the patients were female. Six patients of them were asymptomatic and detected to have the lesion at a medical checkup, and five patients were operated on via sacral approach.

Journal

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

    Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 59(4), 1150-1153, 1998-04-25

    Japan Surgical Association

References:  14

Cited by:  8

Codes

  • NII Article ID (NAID)
    10008436236
  • 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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