腹腔鏡下に切除した成人S状結腸間膜lymphangiolipomaの1例

Laparoscopic surgery for mesenterial lymphangiolipoma of sigmoid colon : A case report

◆要旨：症例は37歳の男性で，下腹部痛を主訴に近医を受診，骨盤内に囊胞性腫瘤を指摘され，当院に紹介となった．腹部CT・MRIでS状結腸間膜内に多房性囊胞性腫瘤が認められた．腸間膜に発生した囊胞性の良性腫瘍と考え，腹腔鏡手術を施行した．病理組織診では，脂肪組織内にリンパ管腫様の部位が認められ，lymphangiolipomaと診断された．術後再発は認められていない． Lymphangiolipomaは非常に稀な良性腫瘍で，他の腸間膜原発良性腫瘍と同様に完全切除が治療の原則となる．今回，lymphangiolipomaに対して腹腔鏡手術で根治手術を施行し得た1例を経験したので報告する．

　A 37 years old man who had abdominal pain was admitted to our hospital with a suspicion of intrapelvic cystic tumor. Contrast-enhanced abdominal computed tomography scan and magnetic resonance image revealed multilocular cystic mass in the peripheral sigmoid colon mesentery. There were no findings suspicious for malignancy. The patients underwent laparoscopic -assisted sigmoid colectomy. Pathological findings showed lymphatic malformation inside a mature adipose tissue, and we diagnosed the tumor as lymphangiolipoma. Lymphangiolipoma is an extremely rare, benign neoplasm. The patient made an uneventful recovery and has no evidence of recurrence, 3 years after surgery. The principal treatment for this neoplasm is surgical resection, and complete excision is quite important to prevent recurrence. We report this case with a review of the literature.