横行結腸線維腫の1例とその文献的考察

A Giant Fibroma of the Transverse Colon

　大腸に発生する非上皮性腫瘍は，きわめてまれな疾患であり，なかでも線維腫の報告は非常に少ない．最近われわれは，注腸造影，血管造影，腹腔鏡，手術を施行し，興味ある知見を得た横行結腸線維腫の1例を経験したので，文献的考察を加えて報告する．

　A 32 year-old female was seen on May 22, 1976, with a complaint of abdominal distension. A round, firm, 12～13cm in diameter and smooth tumor was palpated on her right abdomen. Barium enema study showed that the transverse colon was displaced downwards, and a diverticulum-like shadow located at the proximal transverse colon was tracted medially and twisted. Superior mesenteric angiogram demonstrated several tumor vessels, which were irregular in diameter and distorted, in the branches of the middle colic artery, while neovascularization and tumor stain were not seen in this area. The histological diagnosis of biopsy specimens taken under laparoscopy was fibroma. The operation was performed under the diagnosis of primary fibroma at the transverse colon with an extraluminal growth. The total extirpation of the tumor was performed with partial transverse colectomy and partial resection of jejunum and ileum. The tumor was 11× 14×10 cm in size, 770 g in weight, and with a whitish somewhat pink color and a firm, homogenous consistency. It is thought that the tumor has grown out from a part of the wall of the proximal transverse colon, and has had an extraluminal growth. The histology of the resected specimen was fibroma. Fibroma of the colon and rectum is such a rare tumor that only 7 cases have been reported in Japan. The case disclosed interesting and specific characteristics of radiologic and angiographic appearances and operative findings and a review of relevant literatures were made.