多臓器圧迫症状を来し囊胞摘出術を行った巨大前立腺囊胞

Surgical treatment for giant multilocular prostatic cystadenoma including multiple organ compression symptoms : A case report

　50歳男性．主訴は左下肢疼痛としびれ，肛門付近の疼痛と尿閉，便秘．CTで直径15cmの骨盤内を占める充実成分を伴う多房性の囊胞性腫瘤が認められた．直腸および膀胱，前立腺は右方に圧排されていた．MRIでは前立腺由来の囊胞性病変と囊胞内の出血が疑われたが，良悪性を含め質的診断は困難だった．症状改善のため骨盤内腫瘍摘出術が施行された．病理組織学的に，囊胞壁がPSAで染色され前立腺囊胞腺腫と診断された．

Abstract

A 50 year - old man visited our hospital due to left lower limb pain and numbness, urinary retention and lower abdominal pain. Contrast-enhanced CT and MRI showed a large retroperitoneal multilocular cystic mass with solid component in the pelvis cavity, measuring 150mm in size. This tumor displaced the bladder, prostate and rectum to the right side. Left hydroureter was also shown. The cystic disease originated from prostate or seminal vesicle is suspicious, however, accurate pre-operative diagnosis is unclear. He underwent resection of the tumor. Histologically, the tumor cystic wall was composed of epithelial cells showed positive immunohistochemical staining of the epithelial prostatic specific antigen, the final pathological diagnosis was prostatic cystadenoma (Rinsho Hinyokika 75: 157-161, 2021).