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消化管に発生する滑平筋腫瘍は,比較的まれとされている.とくに横行結腸を原発とするものはきわめてまれで,本邦において,筆者らが集め得た症例数はわずか3症例の報告を見出すに過ぎない.われわれは横行結腸の筋腫瘍の1症例を経験したので,ここに文献的考察を加えて報告する.
Leiomyoma originating from the digestive tract is of rare occurrence; especially that arising from the transverse colon is reportedly so seldom that in our country we have been able to collect no more than three cases so far. The present case is described here with some comments on its literature.
The patient: a 39-year-old man with a chief complaint of a palpable tumor mass in the abdomen. After undetermined abdominal complaints of about two years' duration, he visited our department for thorough check-up. He was then subjected to barium enema study of the colon.
X-ray findings: A shadow defect was noticed at the site corresponding to a palpable tumor. The border between the shadow defect and the adjoining regions was smooth. During fluoroscopy of the colon we noticed that barium enema was retained at the site tumor despite frequent changes of the patient's position. It was quite clear that the constriction was permanent, so that a diagnosis of a benign neoplasm in the transverse colon was arrived at. He was then referred to the department of surgery.
Special studies at admission: No abnormality was seen in the blood, feces and urinalysis.
Findings at operation: The tumor had arisen from the right side of the transverse colon, adhering to both the caul and mesentery. Its size was 5.0×5.0×5.0 cm. The transverse colon was excised for 20 cm long with the tumor in the center, followed by end-to-end anastomosis.
Histologic findings of the resected specimen: The tumor arose from the medial part of the colon, involving both the anterior and posterior wall. Ulcer was not recognized. The tumor was fibromyoma and there was no trace of malignancy. Seven years after the surgical intervention the patient is in good health, but he is still placed under observation as there is a possible problem of malignancy in the future.
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