腹腔鏡下手術により摘出した後腹膜神経鞘腫の1例

LAPAROSCOPIC RESECTION OF RETROPERITONEAL SCHWANNOMA: A CASE REPORT

　症例は59歳，女性。右季肋部痛が出現し当院内科を受診。腹部超音波，CTで右副腎腫瘍と診断され当科に転科し，腹腔鏡下に腫瘍摘出術を行った。腫瘍は，大きさ6.5×5×4.5cm，重さ80gと大きく，組織学的に後腹膜神経鞘腫と診断された。後腹膜神経鞘腫は，術前に確定診断を下せることは非常に稀であるが，乏血管性で，周囲組織との剥離も容易であり，腹腔鏡下副腎摘除術とほぼ同様の手技で安全に摘出し得ると考えられた。

A 59-year-old woman visited our hospital with the com-plaint of right hypochondrial pain. Abdominal ultrasound, CT scan and MRI showed right retroperitoneal tumor possibly arised from the adrenal gland. We performed laparoscopic tumor resection together with the adrenal gland. The size and weight of the tumor were 6.5×5×4.5cm and 80g, respectively. Pathological diagnosis was retroperitoneal schwannoma. It was difficult to make a differential diagnosis between retroperitoneal schwan-noma and adrenal tumor preoperatively. However, the tumor was localized and hypovascular, and successfully removed under laparoscopic surgery.