胃幽門部のheterotopic cystic malformationの1例

A Case of Heterotopic Cystic Malformation of the Stomach

　胃における良性の上皮性粘膜下腫瘍は，①副膵（迷入膵），②粘膜下の上皮性囊胞性腫瘍の二種類からなっている．しかしながら発生頻度からすれば，ほとんど大多数は前者であり，後者に関する報告文献は世の東西を問わずきわめて稀少である．佐野¹⁾の調査によると「本邦においては，神奈川成人病センターからの1例が報告されているだけである．また外国における症例報告でも次に記載する4症例にすぎない」ということである．

その内訳は下記の通りである．

　第1例　1947年　報告者 Scottによるdiffuse congenital cystic hyperplasia of stomach.

　第2例　1963年　報告者 Obermannのdiffuse heterotopic cystic malformation.

　第3例　1966年　報告者 Tchertkoffのdiffuse cystic malformation of stomach.

　第4例　1970年　報告者 Ignatiousのmultiple diffuse cystic disease of the stomach.

　最近，緊急入院した患者がX線胃バリウム検査所見で胃癌を疑って手術したところ，病理組織学的検査所見からはheterotopic cystic malformation of the stomachというきわめて珍らしい診断であったので報告する．

　There are two kinds of epidermal submucous tumors of the stomach ; one is a parapancreatic (aberrant pancreatic) tumor, and the other an epidermal submucous cystic tumor. As to the incidence of these two kinds of tumors, by far the largest number of cases belong to the former, and extremely few cases of the latter have been reported in the literature either in the East or in the West. According to the investigation by Sano¹⁾, only one such case has been reported from the Kanagawa Senile Disease Center in our country, and only four cases are found in the foreign literature: case 1, diffuse congenital cystic hyperplasia of the stomach reported by Scott (1947) ; case 2, diffuse heterotopic cystic malformation of the stomach by Obermann (1963) ; case 3, diffuse cystic malformation of the stomach by Tchertkoff (1966) ; and case 4, mutiple diffuse cystic disease of the stomach by Ignatious (1970).

　Recently we had a patient admitted into our hospital as an emergency case, who, on being examined by x-ray with barium sulfide, was suspected of having stomach cancer. But when he underwent operation and had his case examined histopathologically, it was diagnosed as heterotopic cystic malformation of the stomach.