後腹膜血管肉腫

THE RETROPERITONEAL HEMANGIOSARCOMA

　51歳男性。腰痛を主訴とする左鎖骨上窩リンパ節転移を伴う後腹膜腫瘍にて当科に入院した。手術は腫瘍生検のみを行い，試験開腹にとどめざるを得なかった。その後化学療法（ADM,VBL,CPA,PEP,Dexamethasone）を行い，一時期腫瘍は縮小したが，1ヵ月半後に腫瘍内出血がきっかけとなり死亡した。病理組織学的には血管内腔腫瘍細胞の増生，血管の増生状態や管腔構造を認め，後腹膜血管肉腫と診断された。

The 51-year-old man admitted because of lumbago, loss of appetite and weight loss. CT-scan, sonography, ⁶⁷Ga scientigraphy and angiography showed retroperitoneal tumor with multiple lymphnode metastasis. Exploratory laparotomy was done, and histology of the biopsyspecimen revealed malignanttumor, but its origin was not clear. Systemic chemotherapy (Adriamycin, Pepleomycin, Vinblastine, Cyclophosphamide. Dexamethasone) was performed/ and the tumor regression was marked for 2 weeks. The patient subsequently died of intratumoral bleeding around 50 th day after the chemothrapy.