腹壁再建を要した尿膜管癌

URACHAL CARCINOMA REQUIRED ABDOMINAL WALL RECONSTRUCTION: A CASE REPORT

　患者は60歳，女性。主訴は下腹部腫瘤。CT,MRIにて膀胱頂部より臍部へ達する腫瘤を認め尿膜管癌と診断した。腫瘍を含め皮膚，腹直筋，腹膜，膀胱頂部を一塊として摘出した。その際の腹壁欠損部にはマーレックスメッシュによる再建術を施行した。病理組織所見はムチン分泌性腺癌であった。また，血清CEAが高値であったが，手術後正常化した。

A 60-year-old woman presented with lower abdominal mass. CT and MRI demonstrated a tumor extending from the dome of urinary bladder to umbilicus, and we made the diagnosis of urachal carcinoma. Partial cystectomy and wide resection of the tumor including skin, rectus muscle and peritoneum were performed. Marlex mesh was used to repair the defect of large abdominal wall. Histopathological examination revealed mucin producing adenocarcinoma. The plasma CEA level which was elevated preoperatively decreased to normal range after the surgery.