有症状の傍神経節腫に対し，3ポートによる腹腔鏡下腫瘍切除術を施行した1例

Symptomatic paraganglioma treated by 3-port laparoscopic tumor resection : A case report

◆要旨：傍神経節腫（paraganglioma）は副腎外発生のカテコールアミン産生腫瘍で，悪性高血圧から各種合併症を生じることもある．今回，3ポートによる低侵襲手術を行い，症状改善を認めた1例を経験したので文献的考察を加えて報告する．症例は40歳の男性で，健診の超音波検査で総腸骨動脈分岐部に腫瘤を指摘された．血中ノルアドレナリン（NAd）高値で傍神経節腫が疑われた．3ポートによる内視鏡手術で血圧変動に注意しながら，フレキシブルスコープを用いた多方向からの観察と慎重な剝離操作で安全に腫瘍摘出を行った．術後は血圧・血糖値が安定化したため，術前使用していた降圧薬・経口血糖降下薬は中止し退院することができた．

　We report a case of paraganglioma successfully treated using minimally invasive surgery. The patient was a 40-year-old man presenting with a mass at the common iliac artery bifurcation during an ultrasound examination. The high level of noradrenaline in the blood suggested paraganglioma. Paraganglioma is a catecholamine-producing tumor that originates from the extra-adrenal glands, leading to various complications due to malignant hypertension. We performed endoscopic minimally invasive surgery using three ports. Tumor removal was performed safely through a careful peeling technique via a multifaceted approach, preventing blood pressure variations. The blood pressure and blood glucose levels were stabilized after the operation. Preoperative anti-hypertensive and peroral hypoglycemic drugs were then discontinued, and the patient was discharged. We report this rare case that was successfully treated using endoscopic surgery with literature review.