遊離空腸移植後に発生した頸部腸管囊胞の1例

A case of enteric cyst arising in the neck after free jejunum transplantation

はじめに

　腸管囊胞は胃腸管囊胞とも呼ばれ，囊胞内面が病理組織学的に胃・腸管粘膜上皮と相同の消化管上皮で構成される囊胞である。縦隔，腹腔，腹壁，脊髄腔などに発生する，もともと珍しい疾患であり^1），頭頸部領域での報告はさらに稀である。今回われわれは，下咽頭がんに対し咽喉食摘，遊離空腸移植を行った後に，頸部に発生した腸管囊胞の1例を経験したので報告する。

　A 68-year-old man was diagnosed with advanced hypopharyngeal carcinoma, and underwent total pharyngolaryngoesophagectomy, bilateral neck dissection and free jejunum transplantation followed by postoperative chemoradiotherapy. He developed an ipsilateral cervical mass 6 month after surgery. On CT, the mass was irregularly shaped and 18 mm in diameter with peripheral contrast enhancement. Significant FDG accumulation was seen at the mass on PET. Lymph node metastasis was strongly suspected, however, biopsy or fine-needle aspiration cytology showed no malignancy. Resection of the mass was eventually performed, and histopathological examination revealed the presence of intestinal mucosa. The origin of the intestinal tissue was presumed to be a fragment of the transplanted or monitor jejunum.