A Case of von Hippel-lindau Disease Diagnosed from Paraganglioma Developing in the Mesocolon Removed at Surgery for Ascending Colon Cancer

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  • 上行結腸癌手術時に切除された腸間膜傍神経節腫から診断されたVHL病の1例
  • 症例 上行結腸癌手術時に切除された腸間膜傍神経節腫から診断されたVHL病の1例
  • ショウレイ ジョウギョウ ケッチョウ ガン シュジュツジ ニ セツジョ サレタ チョウ カンマク ボウ シンケイセツ シュ カラ シンダン サレタ VHLビョウ ノ 1レイ

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Abstract

A 62-year-old woman with a past history of undergoing surgery for solitary cerebral hemangioblastoma visited our hospital for positive reaction to the fecal occult blood examination. She was diagnosed with ascending colon cancer by colonoscopy. Preoperative enhanced computed tomography findings showed small masses around the ascending colon and a hyper-vascular mass around the right branch of the middle colic artery, which were diagnosed with #211 and #222 lymph nodes metastases, preoperatively. Laparoscopic right hemicolectomy with D3 lymph nodes dissection was performed. The #222 lymph node was within the excision area. A white tumor was found beside the right branch of the middle colic artery during the surgery. Moreover, no abnormal findings such as hypertension were observed during the surgery. Based on the histopathological examination, the #211 lymph nodes were diagnosed as lymph nodes metastasis of ascending colon cancer, however, the mass considered as #222 lymph node metastasis was diagnosed with paraganglioma. Since she had the medical history of developing solitary cerebral hemangioblastoma, she was clinically diagnosed with von Hippel-Lindau disease. Paraganglioma is a very rare tumor in the mesocolon, however, when hyper-vascular tumors are found in the mesocolon by preoperative tests, the possibility of paraganglioma should be considered with attention to past medical history.

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