内視鏡的に切除した回腸末端カルチノイドの1例

A Small Carcinoid Tumor in the Terminal Ileum Resected by Endoscopic Mucosal Resection, Report of a Case

要旨　症例は50歳，女性．精神分裂病にて他院入院中，内痔核よりの出血のため当院転院．内痔核の治療後念のために施行した下部消化管内視鏡検査にて終末回腸部にやや黄色調の小隆起病変を発見した．隆起の表面は平滑で血管が透見された．生検にてカルチノイドと診断され，患者背景，家族の希望により内視鏡的切除を施行した．病変は合併症なく完全に切除され，最大径4mmで深達度はsmであった．本例は治療前に内視鏡検査にて診断しえた本邦報告例中最小の回腸カルチノイドであった．

　A fifty-years-old female who had suffered from schizophrenia. A small yellowish sessile elevated lesion was found by endoscopy in the terminal ileum and was diagnosed as a carcinoid tumor by biopsy. Endoscopic mucosal resection (EMR) was carried out because both the patient and her family refused an operation. The tumor was perfectly resected with surrounding normal mucosa. Histologically, it was 4 mm in size and was diagnosed as a carcinoid tumor without any malignant behavior and both vertical and horizontal cut ends were free of carcinoid tissue.