胃壁内転移巣と腫瘍内出血を認めた胃近傍hemangiopericytomaの1例

Hemangiopericytoma with Intratumoral Bleeding and Intramuscular Metastasis of the Stomach, Report of a Case

要旨　hemangiopericytomaは血管外皮細胞から発生する比較的まれな腫瘍である，突然の貧血と意識消失で発症した53歳，女性で消化管出血は認めず，精査で胃幽門大彎近傍に嚢胞状腫瘤を認めた．手術を施行したところ胃幽門壁内に充実性腫瘤と幽門大彎側に血腫を含む腫瘤を認め，鍍銀染色で染まる腫瘍細胞間の好銀線維と電顕所見からhemangiopericytomaと診断した．術後43か月経過したが再発はみられていない．わが国では胃原発のhemangiopericytomaは18例が報告されている．本例のように意識消失を来す腫瘍内出血を生じた例は文献上報告がない．

　Hemangiopericytoma is a relatively rare tumor originating from pericytes in organs. A 53-year-old woman was admitted to our hospital with sudden anemia and faintness. She had no history of gastrointestinal bleeding, but a fist-size tumor in the area around the gastric antral greater curvature was found. Subtotal gastrectomy was performed and it was shown that the tumor consisted of a 1.5 cm intramuscular tumor at the antrum and a 4 cm tumor with hematoma at the antral greater curvature. The tumor was histologically diagnosed as hemangiopericytoma by using the silver impregnation method for detecting silver staining fibers and the electron microscope. Recurrence has not been noted for 43 months. Up to date, 18 cases of hemangiopericytoma originating from the stomach have been reported in Japan, but there has been no case known to have caused anemia due to intratumoral bleeding.