腹腔鏡下および経仙骨的に摘出した巨大成人仙骨部奇形腫の1例

A case of giant adult sacral teratoma resected laparoscopic and transsacral approach

◆要旨：症例は32歳の女性，出生児より臀部腫瘤を指摘され経過観察されていた．当院産婦人科での妊娠出産を機に当科紹介となり，仙骨部奇形腫の診断に至った．腫瘍は臀部皮膚直下から直腸後腔まで至り最大径110mmであり，腹腔鏡併用経仙骨的腫瘍摘出術を施行した．腹腔鏡を併用することで直腸背側まで増大した腫瘍についても遺残なく切除可能であった．腫瘍内容物は毛髪や脂肪成分が含まれており，病理組織学的検査で成熟囊胞性奇形腫と診断された．成人仙骨部奇形腫は稀であり，腹腔鏡を併用し切除した報告も少ないため，文献的考察を加え報告する．

　A 32-year-old female had been pointed out with a buttock mass since childhood and had been under observation. After pregnancy and childbirth at gynecology department in our hospital, She was introduced to our department because of the mass. After examinations, she was diagnosed with sacral teratoma. The tumor had a maximum diameter of 110 mm from just below the buttock skin to the posterior space of the rectum. The teratoma was too big to resect with transsacral approach, so we performed surgical resection with laparoscopic and transsacral approach. The tumor contents contained hair and fatty components, and histopathological diagnosis was a mature cystic teratoma. Since adult sacral teratomas are rare and there are few reports of laparoscopic resection, we report this case with literature discussion.