Reduced port surgeryにて完全切除しえた後腹膜原発粘液性囊胞腺腫

Retroperitoneal mucinous cystadenoma resected completely by reduced port surgery : A case report

　22歳女性．血尿と排尿時痛を主訴に近医を受診し，急性膀胱炎の診断で加療を受けた．その際，スクリーニングの超音波検査で後腹膜腫瘍が疑われた．CTおよびMRIで右後腹膜腔に一部充実成分を含む囊胞性腫瘤を認めた．悪性腫瘍の可能性が考えられたため単孔式体腔鏡下後腹膜腫瘍摘除術を施行し，囊胞壁を損傷することなく摘出した．腫瘤は長径7cm大の多房性で，2cm大の表面不整な壁在結節を伴っていた．病理診断は粘液性囊胞腺腫で悪性病変は認めなかった．術後10か月現在，再発を認めず経過している．本疾患は悪性の可能性を有するため，腫瘍を損傷することなく完全に切除することが求められる．低侵襲性と整容性のメリットを併せ持つreduced port surgeryは本疾患に対する手術療法のオプションとして考慮される．

Abstract

A 22-year-old woman presented with the chief complaint of macrohematuria and miction pain and was diagnosed as acute cystitis. Screening ultrasonography showed a cystic mass in right retroperitoneum. Contrast-enhanced CT scan and MRI showed a cystic tumor with a diameter of 8 cm between right kidney and liver. A slightly enhanced mural nodule existed within tumor. We made a diagnosis of retroperitoneal cystic tumor which was suspected to be malignant. We conducted laparoscopic resection of the tumor using reduced port surgery. Pathological examination showed mucinous cystadenoma, and mural nodule was found to be a conglomeration of small cysts without malignancy. We here in report a case of retroperitoneal mucinous cystadenoma which was completely resected by reduced port surgery (Rinsho Hinyokika 72 : 933-938, 2018).