無症状で発見された空腸平滑筋肉腫の1例

Jejunal Leiomyosarcoma Diagnosed in Asymptomatic Stage

　われわれは小腸疾患に興味を持っているが，最近集団検診で胃の異常をチェックされた消化器症状の全くない例に，比較的早期と思われる空腸平滑筋肉腫の1例を経験したので報告する．

　A 64-year-old man visited our hospital without abdominal complaints to undergo the further examination of the stomach because some abnormal finding in the stomach was suspected by x-ray mass survey of upper gastrointestinal series.

　Physical examination and laboratory data showed only a slight anemia. At upper gastrointestinal series, a shadow of tumor of quail's egg size with transverse dell was observed in the upper jejunum, 15cm distal from the Treitz's ligament. This tumor was demonstrated more clearly by cmpression and double contrant techniques. There were no abnormalities including dilatation and stenosis in other small intestine.

Angiography was not performed because of iodine hypersensitivity.

　Though endoscopy was not carried out, the tumor was diagnosed as leiomyoma or leiomyosarcoma because the tumor had a transverse dell on the top of it with smooth surface on the other parts.

　Gross appearance of the resected jejunum showed hour glass type myogenic tumor, consisting of a smooth surfaced tumor measuring 35×27 mm on the jejunal mucosa and an uneven surfaced tumor measuring 25×25mm on the jejunal serosa. Histologically the tumor was leiomyosarcoma of low grade malignancy.