増大傾向を示した卵巣腫瘍術後の後縦隔Müller管囊胞の1例 A case of an enlarging posterior mediastinal Müllerian cyst after ovarian tumor surgery

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<p>症例は43歳,女性.2年前に右卵巣顆粒膜細胞腫に対して右付属器摘除術が行われた.その経過観察中に胸部CTで第4胸椎左前方に増大傾向を示す21×14×26 mm大の内部均一で境界明瞭な腫瘍を認めた.MRIではT1で低信号,T2で高信号を示し囊胞性腫瘍を疑う所見であった.診断治療目的に胸腔鏡下後縦隔腫瘍摘除術を施行した.腫瘍は薄い被膜を有し,内部は液体成分の囊胞性腫瘍であった.周囲組織との癒着や神経との連続性は認めなかった.病理結果において,腫瘍の被膜は単層または複層の線毛円柱上皮で一部内腔へ乳頭状に突出していた.免疫染色ではEstrogen Receptor(+),Progesterone Receptor(+)でありMüller管囊胞と診断した.後縦隔Müller管囊胞は閉経や肥満,婦人科疾患の手術との関連性が指摘されており,本症例は卵巣腫瘍の術後に増大傾向を示した.</p>

<p>The patient was a 43-year-old woman who had undergone unilateral ovariectomy for a right ovarian granulosa cell tumor two years previously. Follow-up CT revealed a well-circumscribed and homogenous mediastinal tumor, of 21×14×26 mm. The tumor was located anteriorly to the left side of the fourth thoracic vertebra and had been enlarging. Chest MRI revealed a low intensity in the T1-weighted image and high intensity in the T2-weighted image, which indicated that the tumor was a cystic lesion. For diagnosis and treatment, thoracoscopic posterior mediastinal tumor resection was performed. The tumor had a thin capsule within the fluid component and had no adhesion or continuity with the surrounding tissue, including nerves. Pathologically, the inner cells of the tumor capsule formed a mixed monolayer and multilayered ciliated columnar epithelium that partially protruded into the lumen, with a papillary appearance. Immunohistologically, the epithelia were positive for estrogen and progesterone receptors. From these results, the tumor was diagnosed as a Müllerian cyst. In the literature, Müllerian cysts have been associated with menopause, obesity, and surgery for gynecological diseases. In the present case, the tumor grew after surgery for an ovarian tumor.</p>

収録刊行物

  • 日本呼吸器外科学会雑誌

    日本呼吸器外科学会雑誌 32(6), 753-757, 2018

    特定非営利活動法人 日本呼吸器外科学会

各種コード

  • NII論文ID(NAID)
    130007484293
  • 本文言語コード
    JPN
  • ISSN
    0919-0945
  • データ提供元
    J-STAGE 
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