腹腔鏡下に切除した副腎皮質原発solitary fibrous tumorの1例

A case of solitary fibrous tumor originated from the cortex of the adrenal gland treated by laparoscopic surgery

◆要旨：患者は70歳，女性．腹部超音波検査で偶然に左副腎に腫瘤を指摘された．造影CTでは左副腎と連続する約40mm大の境界明瞭な腫瘤を認めた．血液生化学検査では明らかな異常はなく，非機能性副腎腫瘍の診断で腹腔鏡下に摘出術を施行した．病理組織学的には核異型の乏しい紡錘形細胞の増殖で構成され，免疫染色でCD34陽性，vimentin陽性であった．以上より副腎皮質原発solitary fibrous tumor（SFT）と診断した．SFTは組織学的悪性度が低くとも局所再発や遠隔転移などの悪性転帰をたどることがあり，本症例においても厳重な経過観察が必要と考えられた．

A 70-year-old woman was referred to our hospital for further examination and treatment of a left adrenal tumor that was detected on abdominal ultrasonography. Abdominal computed tomography showed a well-defined 40mm tumor adjacent to the left adrenal gland. We resected the tumor laparoscopically based on a diagnosis of nonfunctioning adrenal tumor. The resected specimen was a 60×40×40mm solid tumor with a grayish-white cross-section. Histologically, the tumor consisted of spindle cells presenting a “patternless pattern”. Immunohistochemically, the specimen tested positive for CD34 and vimentin but negative for CD31, α-SMA, S-100, EMA and desmin. The tumor was definitively diagnosed as a solitary fibrous tumor originated from the cortex of the left adrenal gland. The patient is alive without recurrence 20 months after the operation.