術前に大網囊腫と診断し内視鏡下に摘出術を施行した1例

A case of omental cyst with diagnosed preoperatively and resected laparoscopically

◆要旨：患者は32歳の女性．2007年7月，上腹部腫瘤を主訴に近医を受診し，膵囊胞性疾患を疑われ，精査目的に当院に紹介となった．腹部CT検査で，境界明瞭な囊胞性病変が指摘された．また前医でのCTと比較し病変が移動しており，可動性が指摘され,大網または腸間膜に由来する病変が疑われた．MRCPでは主膵管の拡張や病変と主膵管との連続性は認めなかった．2008年10月，腹腔鏡下腫瘍摘出術を施行した．病変は胃結腸間膜内にあった．全周性に剝離し腫瘍摘出術を行った．術後経過は良好で第4病日に退院した．病理組織学的には悪性所見はなく，リンパ囊腫と診断された．成人大網リンパ囊腫は稀な疾患であり，文献的考察を加えて報告する．

　We present a case of a 32 year old female with omental cystic lymphangioma. The patient had complained of upper abdominal mass and was referred to the outpatient unit as cystic lesion arising from the pancreas. Ultrasonography and abdominal computed tomography （CT） scan revealed a well-defined, homogeneous cystic lesion. Comparison with previous CT scan demonstrated the mobility of the cystic lesion. MRI did not show communication between the cyst and pancreatic ducts. Preoperative diagnosis of the cystic lesion was omental cyst. Laparoscopic resection of the mass was performed. There were no postoperative complications and the patient was discharged on the fourth postoperative day. Microscopic examination showed no signs of malignancy and the cystic mass was diagnosed as a cystic lymphangioma of the omentum. We report a case of omental cystic lymphangioma and discuss its clinical features, diagnosis and management.