腹腔鏡下に切除したS状結腸神経鞘腫の1例

Laparoscopic resection of schwannoma of the sigmoid colon : a case report

◆要旨：神経鞘腫の消化管発生は少なく，特に大腸原発は稀である．症例は86歳の男性で，下腹部不快感を主訴に当院を受診し，注腸検査でS状結腸に表面平滑・辺縁整な30×30mm大の隆起性病変を認めた．大腸内視鏡検査では同部位に表面平滑な粘膜下腫瘍を認めた．S状結腸粘膜下腫瘍と診断し，腹腔鏡下S状結腸切除術を施行した．病理組織学的所見は軽度異型のある紡錘形細胞が比較的密に増殖し，免疫組織化学的染色ではS‐100蛋白陽性，c-kit陰性であり，S状結腸神経鞘腫と診断した．

　Schwannomas of the digestive tract are rare, especially in the colon. An 86-year-old man visited at our hospital with the symptom of lower abdominal discomfort. Smooth tumor mass measuring of 30×30 mm was detected in the sigmoid colon by barium enema. Colonoscopy showed a submucosal tumor. Laparoscopic sigmoidectomy was performed with the diagnosis of submucosal tumor. Pathologic examination of the tumor revealed densely proliferated spindle cells with a slight atypical appearance. Immunohistologically, the tumor cells were positive for S-100 protein and negative for c-kit; the lesion was diagnosed as Schwannoma.