鼠径ヘルニア術後に発生した縫合糸による膀胱周囲肉芽腫

Paravesical suture granuloma following inguinal herniotomy:A case report

　65歳，男性。1年前に左鼠径ヘルニア手術の既往あり。主訴は顕微鏡的血尿。膀胱鏡で，充実性の腫瘤を膀胱頂部に認めた。2度にわたりTURを施行したが，病理診断ではdysplasiaおよび炎症であつた。2か月後に腫瘤は膀胱の同部位に再発し，短期間で増大したため，膀胱部分切除術を施行した。その結果，肉芽組織に囲まれた絹糸を認めた。過去に膀胱手術の既往がないため，縫合糸は鼠径ヘルニア手術に関連したものと考えられた。

A 65-year-old man with left inguinal herniotomy oneyear previously was referred to us for the check ofmicrohematuria. The solid mass located at the dome ofbladder was detected by cystoscopy. Repeated TURrevealed dysplasia and cystitis with no malignancy. Twomonths after the last operation, there occurred recur-rence of the mass in the same location of the bladderwith the size of the mass increased in short term. Weperformed partial cystectomy and found silk sutureswith surrounding granulation tissue. Because he had nohistory of bladder operations, we suspected suturegranuloma resulted from previous inguinal herniotomy.