腸重積を伴った回盲部細網肉腫の1例

Reticulosarcoma of the Ileocecal Region accompanied with Intussusception, a Case Report

　腸管に発生する悪性リンパ腫は，比軽的稀な疾患とされている．筆者らは最近，腸重積を伴った回盲部細網肉腫を経験したので報告する．

症例

　患　者：61歳　男子　鮮魚商

　家族歴・既往歴：特記すべきものなし．

　現病歴：昭和48年夏頃より腹部膨満感あり，便通があると消失したが，便通異状，下血などは伴っていなかった．同じ頃より，回盲部に患者自身，腫瘤をふれるのに気づいたが，腫瘤は，日々よりふれたりふれなかったりした．49年1月，腹部膨満感，回盲部腫瘤を主訴として来院した．

　A man aged 61 came to our hospital with chief complaints of sense of distention and palpable mass in the abdomen. On admission we noticed a mobile tumor in the abdomen which was palpated off and on. Barium enema examination revealed an oval tumor with smooth contour hardly suggestive of cancer.

　It was difficult to judge whether it was an ileocecal tumor or the defect was due to bowel displacement of extramural origin. Diagnosis at surgical intervention was reticulosarcoma accompanied with intussusception. The present case gave us an opportunity to investigate 67 such cases reported in the literature (1968～1974).

　We have reviewed it by comparing our case with the studies of other workers. In frequency the male outnumbers the female. This tumor, although not so frequent as cancer, is most often seen in the age groups 50～59, 60～69 and over 70. The majority of the tumor originate in the ileocecal region. No symptom characterizes it.

　Often it would be accompanized with intussusception, so that careful diagnosis is necessary. Preoperatively it is hard to arrive at correct diagnosis partly because there is no characteritic finding in roentgenogram. Early detection and timely management is therefore hard to make. Prognosis is worse than in the tumor in the category of sarcoma.

　Five-year-survival is infrequent. Early detection of this type of tumor calls for accurate diagnosis by employing intestinal fiberscopy for direct vision observation and biopsy.