腹膜偽粘液腫をきたしたS状結腸癌の1例 A CASE OF PSEUDOMYXOMA PERITONBI ASSOCIATED WITH SIGMOID COLON CANCER

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腹膜偽粘液腫の原発巣のほとんどは虫垂または卵巣である.今回,稀なS状結腸原発の腹膜偽粘液腫を経験した.症例は59歳,女性.腹部腫瘤,機械性腸閉塞にて入院となった.右下腹部に境界明瞭で表面平滑,成人頭大の腫瘤を認めた.術前検査でS状結腸の狭窄とそれに連続する充実性部分を伴った嚢胞性腫瘤を認めた.手術は腫瘤,S状結腸,小腸,両側卵巣,子宮,虫垂切除を施行した.嚢胞内は膿と粘液様物質で充満し,S状結腸から嚢胞内に連続する腫瘤を認めた.組織学的にS状結腸粘膜面は腺管絨毛腺腫内高分化型腺癌で深層に進むにつれ粘液癌の像を呈していた.手術後6カ月で腹腔全体に粘液が充満する状態となり,悪液質のため死亡した.本症例は虫垂,卵巣に粘液産生腫瘍を認めず,結腸原発の腹膜偽粘液腫と診断した.

The common primary site associated with pseudomyxoma peritonei (PP) is the appendix or the ovary. We report a case of PP resulting from sigmoid colon cancer. A 59-year-old woman admitted for an abdominal mass and mechanical intestinal obstruction was found to have a large, well-defined mass parpable in the right lower abdomen. Enema radiography showed stenosis of the sigmoid colon, computed tomograpay (CT) and magnetic resonance imaging (MRI) showed a mass having a cystic and solid portion. Combined resection of the tumor, sigmoid colon, small bowel, bilateral ovaries, uterus, and appendix was done. The cystic portion of the mass was filled with pus and mucinous fluid. The solid portion had continuity to the sigmoid colon. Histological examination of the sigmoid colon showed well differenciated adenocarcinoma developed in a tubullo-villous adenoma, and mucinous carcinoma. Mucinous carcinoma was located in the deep layer of the tumor. No evidence suggested the presence of a primary mucinous neoplasm in the appendix or ovaries. Six months later, the abdominal cavity filled with mucinous fluid and the patient died of cachexia. This case was thus diagnosed as PP associated with sigmoid colon cancer.

収録刊行物

  • 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(4), 950-953, 2002-04-25

    日本臨床外科学会

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  • NII論文ID(NAID)
    10008619036
  • NII書誌ID(NCID)
    AA11189709
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    13452843
  • データ提供元
    CJP書誌  J-STAGE 
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