腹部超音波検査が発見の契機となった小腸平滑筋肉腫の1例

Leiomyosarcoma of the Small Intestine Initially Detected by Abdominal Ultrasound, Report of a Case

要旨　患者は51歳，男性．主訴は腹痛．初診時左下腹部に圧痛あり，同部の腹部超音波検査で多様な超音波所見を呈する腫瘤を検知し，腸管由来の腫瘍と推測した．小腸X線検査では上部空腸に管腔外に発育する腫瘤を認め，中心に深い潰瘍を伴っていた．小腸部分切除を行い，小腸腫瘍は9.0×6.5×3.5cmの平滑筋肉腫であった．切除標本には中心に潰瘍形成があり，それに連なって2か所に大きな血性嚢胞を伴っていた．この割面像と超音波所見は比較的一致していると考えられた．

　A 51-year-old male visited us because of abdominal pain. Abdominal ultrasound showed an isoechoic mass measuring 6 X 4 cm in size, having two low echoic cystic lesions situated on the dorsal site of the intestine. Because of this finding, a tumor derived from the intestinal wall was suspected. Radiography of the small bowel revealed a tumor with extrinsic growth and with deep central ulceration in the upper part of the jejunum. Pathologically the resected specimen was a leiomyosarcoma measuring 9.0 X 6.5 X 3.5 cm in size. The tumor had a central ulceration and two bloody cystic lesions. The ultrasound findings seemed to have clearly depicted the cross section of the specimen.