盲腸に発生した腸管子宮内膜症の1例

Endometriosis of the Cecum, Report of a Case

要旨　患者は48歳，女性．大腸憩室症で近医で経過観察されていた．大腸精査目的で当院受診となるが，初診時の注腸造影では大腸憩室のみで腫瘍性病変は認めず，1年後の注腸造影で盲腸に粘膜下腫瘍様病変の出現をみた．更に3か月後の注腸造影で病変の増大を認めたため，手術を施行した．切除標本における病理組織学的所見で腸管子宮内膜症との診断を得た．本例は1年3か月間に腸管子宮内膜症の出現と増大を認め，その増大の原因として子宮内膜組織の増殖，経血によるヘモジデリン沈着，固有筋層の肥厚，線維化などが考えられた．

　The patient who was a 48-year-old female with colitic diverticulosis had been under observation at a clinic nearby but she visited this hospital for detailed examination of the large intestine. The results of barium enema taken at the first consultation indicated only colitic diverticulosis and no neoplastic lesion. However, a submucosal neoplastic lesion was detected by the barium enema taken one year afterwards. As growth of the lesion was noted by enema barium, three months from then, an operation was conducted. Based on the histopathological findings of the resected specimen, the patient was diagnosed to have intestinal endometrioma. In this patient, the onset and growth of intestinal endometrioma were observed within one year and three months. The proliferation of endometrial tissue, hemosiderin deposition due to menstrual blood, hypertrophy and fibrosis, etc. of the proper muscular layer were assumed to be the causes of growth.