骨盤腹膜に発生したcystic endosalpingiosisに対して腹腔鏡手術を施行した1例

A case of cystic endosalpingiosis in the pelvic peritoneum treated with laparoscopic surgery

◆要旨：症例は52歳，女性．1妊，1産．下腹部痛，腹部膨満感を主訴に当院を受診した．腹部CT検査にて骨盤内に多房性囊胞性病変を認め，2年前のCT検査と比較し増大傾向を示した．卵巣由来もしくは腹膜由来の良性囊胞性腫瘍と診断した．病変の増大傾向があり悪性疾患を否定できず手術を施行した．術中所見で子宮および両側卵巣を中心とした骨盤腹膜の広範囲に多発囊胞性病変を認めた．腹腔鏡下に病変範囲を確認しながら骨盤腹膜切除を行い，子宮全摘術および両側付属器切除術を施行した．術後経過は良好で術後第7病日に退院した．今回骨盤腹膜に発生したcystic endosalpingiosisに対して腹腔鏡手術を施行した症例を経験したので，若干の文献的考察を加えて報告する．

　A 52-year-old woman was admitted to our hospital with a complaint of lower abdominal pain and concomitant abdominal distention. Her obstetric history consisted of one pregnancy and one live birth（G1P1）. Abdominal computed tomography（CT）showed a multilocular cystic pelvic lesion., which demonstrated increased growth compared to a previous CT examination taken two years before. The patient was subsequently diagnosed with a benign cystic tumor derived from the ovary or the peritoneum. As the lesion exhibited increased growth., clinical malignancy could not be ruled out., so laparoscopic surgery was performed. Intraoperative findings revealed multiple cystic lesions extensively spread out around the area of the pelvic peritoneum centered on the uterus and bilateral ovaries. During pelvic peritoneal resection., total hysterectomy and bilateral adnexal resection were also performed. The patient had an unremarkable postoperative course without postsurgical complications and was discharged seven days after surgery. Here., we report a case of cystic endosalpingiosis in the pelvic peritoneum., managed by laparoscopic surgery., with a corresponding review of current literature on the disease.