嚢胞性変化を伴った副腎外褐色細胞腫の1例  [in Japanese] A CASE OF EXTRA-ADRENAL PHEOCHROMOCYTOMA ACCOMPANIED BY CYSTIC DEGENERATION  [in Japanese]

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Abstract

腹部大動脈周囲に発生し,嚢胞性変化を伴った副腎外褐色細胞腫の1例を報告する.<br> 症例は68歳の男性.左側腹部に手拳大の腫瘤を触知し,精査目的で入院した.腹部超音波およびCT検査にて腹部大動脈の左方に,厚い被膜と隔壁を有する境界明瞭な嚢胞性腫瘤を認めた. MRI検査では腫瘤の内部はT2強調像で高信号強度を示した.血管造影では,下腸間膜動脈の起始部付近より分岐する腰動脈からの淡い腫瘍濃染像を認めた.後腹膜腫瘍の診断で手術を施行した.腫瘍の操作時に急激な血圧上昇がみられ,褐色細胞腫を疑った.術中採取した血液および尿中のカテコールアミン値は増加していた.腫瘍は径10×7.5×7cm,重量280gで被膜を有し,割面で隔壁を伴う嚢胞形成がみられた.病理組織学的に褐色細胞腫と診断した.術後1年目に肺癌による癌性胸膜炎で死亡した.巨大な嚢胞性変化を伴った副腎外褐色細胞腫は極めて稀であり,本邦では3例の報告のみである.

We report herein a case of extra-adrenal pheochromocytoma accompanied by cystic degeneration, located at the inferior para-aortic region.<br> A 68-year-old man was admitted to the hospital for evaluation of an abdominal mass in the left upper quadrant. Ultrasonography and computed tomography of the abdomen revealed a large cystic mass with thick capsule and septum. Transverse T2-weighted magnetic resonance images of the abdomen showed a high signal intensity of the mass. Angiography revealed a thin stained tumor, fed by branches from the lumbar artery. Upon surgery, an extra-adrenal pheochromocytoma was suspected because acute hypertensive crisis was induced by manipulation of the tumor. In hormonal examinations of samples collected during the operation, catecholamine levels in both plasma and urine elevated. The resected specimen was an encapsulated tumor, 10×7.5×7cm in size, weighing 280g. In the section, a cystic formation with septum was noted. Histologically, the tumor was diagnosed as pheochromocytoma. The patient died of lung cancer a year after the operation. Reports of extra-adrenal pheochromocytoma accompanied by marked cystic degeneration are extremely rare, and only 3 cases, including this one, have been reported in Japan.

Journal

  • The journal of the Japanese Practical Surgeon Society

    The journal of the Japanese Practical Surgeon Society 58(10), 2434-2438, 1997-10-25

    Japan Surgical Association

References:  17

Cited by:  2

Codes

  • NII Article ID (NAID)
    10008531269
  • NII NACSIS-CAT ID (NCID)
    AN00198696
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    03869776
  • Data Source
    CJP  CJPref  J-STAGE 
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