腹腔鏡下に摘出した後腹膜気管支原性囊胞の1例

A case of retroperitoneal bronchogenic cyst successfully treated by laparoscopic surgery

◆要旨：患者は56歳，女性．上腹部痛を主訴に，上部消化管内視鏡検査，上部消化管造影検査，腹部超音波検査，腹部CT検査を施行したところ，胃粘膜下腫瘍と診断し，手術を施行した．腫瘍は小網内に存在したが周囲臓器との連続性を認めず，後腹膜腫瘍と診断しreduced port surgeryによる腹腔鏡下後腹膜腫瘍摘出術を施行した．摘出標本は45mm大の単房性囊胞で，囊胞内面は線毛円柱上皮で被覆され，気管支腺様の付属器腺，軟骨，平滑筋を認めたことより後腹膜気管支原性囊胞と診断した．後腹膜気管支原性囊胞は稀な先天性の良性疾患であるが，多彩な画像所見を呈するため確実な術前診断が困難であり，診断的治療としてreduced port surgeryのよい適応と考えられた．

A 56-year-old woman with upper abdominal pain was admitted to our hospital. Upper gastrointestinal endoscopy, abdominal ultrasonography and abdominal CT scan revealed a submucosal tumor located on the posterior wall of the upper gastric body. Because invasion into the surrounding organs was not obserbed, the tumor was diagnosed as a benign retroperitoneal tumor. Laparoscopic surgery was performed using the reduced port method. The tumor was a monolocular cyst, 45mm in diameter. Histopathologically, it consisted of ciliated epithelium, cartilage, bronchial glands, and smooth muscle. The pathological diagnosis was a retroperitoneal bronchogenic cyst. Retroperitoneal bronchogenic cyst is a very rare congenital disease, and preoperative diagnosis by imaging is difficult. The preferred option for treatment is surgical resection. Laparoscopic resection using reduced port method is useful for retroperitoneal bronchogenic cyst as a diagnostic and therapeutic procedure.