腹腔鏡下に切除した腹膜原発血管平滑筋腫の1例

Laparoscopic surgery for peritoneal angioleiomyoma : a case report

症例は47歳，女性．右下腹部腫瘤を主訴に来院した．腹部CT・MRI・エコーなどの精査にて，腹腔内腫瘍（平滑筋腫，GISTなどの疑い）の診断を得たが，確定診断に至らなかった．診断・治療目的で，腹腔鏡下に切除を行う方針とした．術中所見では，右下腹壁で腹腔内に突出する形の腫瘍を認め，腸管および腸間膜との関係はなく，腹壁腫瘍と考えた．腫瘍に直接触れないように注意しつつ，腫瘍周囲の腹膜を一部含める形で腫瘍切除を行い，最終病理診断にて血管平滑筋腫の診断を得た．腹膜由来のものはごく稀であるが，このような腹腔内腫瘍に対し，診断・治療目的に腹腔鏡下切除術を行うことは有用な方法と考えられた．

　We report a rare case of peritoneal angioleiomyoma resected laparoscopically in our hospital. A 47-year-old woman felt a mass in her lower abdomen and came to our hospital. She was admitted to the hospital for further examinations. Ultrasonography, abdominal CT and MRI could not diagnose the tumor. Therefore, laparoscopic surgery was performed for diagnosis and treatment. The post operative pathological diagnosis was angioleiomyoma. Although the tumor was completely resected, we should closely observe the patient since the recurrence of this tumor has been reported.