胸腹部に進展した巨大食道平滑筋腫の1例  [in Japanese] A CASE OF GIANT ESOPHAGEAL LEIOMYOMA DEVELOPED INTO THE THORACOABDOMINAL SPACE  [in Japanese]

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Abstract

長径15cmにおよび胸腹部に進展する巨大食道平滑筋腫の1例を経験したので治療を中心に文献的考察を加え報告する.<br> 症例は34歳,男性で, 11年前に下部食道の隆起性病変を指摘されており,上腹部痛を主訴とした.上部消化管透視にてIm食道から胃噴門部にかけての狭窄と,胃体上部小蛮におよぶ隆起性病変を認めた.食道内視鏡では全周性の狭窄を呈するも,粘膜は正常であった.胸腹部のCTおよびMRIにて,食道内腔を全周性に取り巻くように発育し,胸腹部に進展する巨大な食道粘膜下腫瘍を認めた.手術は左開胸開腹横隔膜切開下に下部食道胃体上部切除,空腸間置術を行った.腫瘍は15×10.5×10cm大であり,病理所見で平滑筋腫と診断した.患者は第25病日に退院し,体重減少など食事摂取に関する術後不定愁訴は認めていない.

A case of giant esophageal leiomyoma with 15cm in long diameter developed into the thracoabdominal space is reported with some considerations of the literature. A 34-year-old male with epigastralgia had been pointed out a protrusion in the lower esophagus 11 years before. Upper gastrointestinal series revealed a stenosis from the intrathoracic middle esophagus to cardial lesion. Endoscopic examination revealed a submucosal tumor in the esophagocardiac lesion. CT and MRI showed a giant submucosal tumor circumfused the esophageal lumen and developed into the thoraco-abdominal space. Lower esophagectomy and upper gastrectomy reconstructed with jejunal transfer were performed under the left anterolateral thoracotomy and laparotomy. The resected tumor was 15×10.5×10cm in size, and benign leimyoma histopathologically. Postoperative course was uneventful. The patient was discharged from the hospital on the 25th postoperative day.

Journal

  • The journal of the Japanese Practical Surgeon Society

    The journal of the Japanese Practical Surgeon Society 57(2), 374-378, 1996-02-25

    Japan Surgical Association

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