腹腔鏡補助下手術を施行した前後仙骨部に発生した粘液癌の1例

A case of laparoscopic-assisted surgery for mucinous carcinoma in pre and retro sacral space

◆要旨：患者は71歳，女性．増大する臀部膨隆を主訴に当院を紹介された．画像検査では前仙骨部から後仙骨部にわたる10cm大の囊胞性腫瘤であったが，明らかな充実性成分は認めなかった．経皮的生検を行ったが確定診断は得られなかった．有症状かつ本人の希望もあり，腹腔鏡下，経仙骨的腫瘤摘出術を施行した．腫瘤は直腸を前方に著明に圧排し，また仙尾骨と強固に癒着していたが腸切除を行わず標本を摘出しえた．病理組織学的所見では粘液癌との診断であった．腹腔鏡下手術が有用であった症例を経験したので報告する．

　A 71-year-old woman was admitted to a nearby hospital for increasing distention in the buttocks. Imaging studies showed a 10cm sized cystic tumor in pre and retro sacral space, but solid lesions were not seen. Percutaneous biopsy of the tumor was performed but no definitive diagnosis was obtained. Laparoscopic and transsacral operation was performed because the patient requested surgical treatment. The surgical findings revealed the tumor compressing the rectum and adhering strongly to sacrococcygeal region. Despite these findings, tumorectomy was performed without rectal resection. Histopathological finding revealed mucinous carcinoma. We herein report this rare case with literature review.