腹腔鏡下に切除した胃glomus腫瘍の1例

A case of glomus tumor of the stomach resected by laparoscopic surgery : A case report

◆要旨：患者は77歳，男性．胃粘膜下腫瘍を指摘され精査・加療目的にて当院を紹介され受診した．上部消化管内視鏡検査，超音波内視鏡検査で粘膜下腫瘍と診断されたが，悪性も否定できないため，腹腔鏡下幽門側胃切除術を施行した．病理組織学的所見では小型で均一な異型の少ない，比較的明るい細胞質を有する細胞が筋層内に密に増生しており，免疫染色ではα-SMA陽性，S-100, c-kit, CD 34陰性で胃glomus腫瘍と診断された．胃glomus腫瘍は本邦では比較的稀な疾患であり，腹腔鏡下手術にて切除した症例は過去4例のみであるが，本症は腹腔鏡下手術のよい適応例であると考えられるため，若干の文献的考察を加え報告する．

　A 77-year-old man was admitted to our hospital with a diagnosis of gastric submucosal tumor. The submucosal tumor was detected by endoscopy and endoscopic ultrasonography. The preoperative diagnosis was submucosal tumor of the stomach.

　Laparoscopic distal gastrectomy was performed. Histological examination revealed blood vessels lined by normal endothelial cells and surrounded by sheets of round or oval tumor cells without atypia. Immunohistochemical examination revealed the tumor to be positive forα-smooth muscle actin and to be negative for S-100, c-kit and CD 34. A diagnosis of glomus tumor of stomach was made. Glomus tumor of the stomach is a rare case of gastric submucosal tumor. In Japan only 4 cases have been resected by laparoscopic surgery. Laparoscopic surgery is a valid approach to treatment for glomus tumor of stomach.