腹腔鏡下摘出術を施行した骨盤内巨大類表皮囊胞の1例

A case of epidermoid cyst in the pelvis treated by laparoscopic cystectomy

◆要旨：患者は18歳，男性．2010年3月に心窩部痛を主訴に近医を受診し，腹部超音波検査にて骨盤内腫瘤を指摘された．その後，症状は軽快したが，精査を目的に同年3月末，当院泌尿器科に紹介となった．腹部CTで直腸背側に径9cmの囊胞性腫瘤を指摘され，同腫瘍はMRIでは内部に高信号と低信号の領域を含む囊胞様腫瘤であった．仙骨と腫瘍の間に脂肪の介在は認めないものの骨の破壊像は認めず，仙骨からの神経は圧排を受けることなく走行していた．2010年8月上旬，腹腔鏡下腫瘍摘出術を施行した．病理検査で，重層扁平上皮に裏打ちされた病変で内部に角化物が貯留しており，類表皮囊胞と診断された．

The patient was 18 years old male. He consulted a nearby clinic for epigastric pain in March, 2010, and was noted with a pelvic mass by abdominal ultrasonography. He was suspected to have prostate tumors, so he consulted our hospital department of urology in March, 2010. The prostate was found to be normal. Cystic tumor of diameter 9cm was detected in the dorsal side of the rectum by abdominal CT scan. The MRI showed a region of high and low signal inside. There was no fat between the tumor and sacrum. There was no bone destruction and the sacral nerve was not excluded due to the tumors. On August, 2010, the patient underwent laparoscopic tumorectomy. Pathology revealed keratinized substance accumulated in the lesion wrapped in stratified squamous epithelium. A diagnosis of epidermoid cyst was made. After surgery, recurrence of epidermoid cyst has not been detected.