術前MRIにて漿膜下筋腫または左卵巣線維腫と診断したガーゼオーマの1例

抄録

  We report a case of "gauzeoma" that was first diagnosed as subserous uterine myoma or left ovary fibroma with magnetic resonance imaging (MRI) before the surgery. Case presentation: A 67-year-old woman, gravida 2 para 2, who had a history of tubal ligation surgery at the age of 22 years and appendicitis surgery at the age of 30 years was referred to our department because of an abnormal tumor in her abdominal cavity. She had undergone an MRI examination when she had experienced abdominal pain about a month before the referral. MRI revealed an approximately 55-mm tumor that presented a low signal intensity in both T1- and T2-weighted images. We established a diagnosis of torsion of the subserous uterine myoma or left ovary fibroma, and performed a laparoscopic surgery. The tumor was covered by adipose tissue and adhered to the abdominal wall. We separated the tumor from the adhesion and then found gauze material in the tumor, which we diagnosed as "gauzeoma." The adhesion between the gauzeoma and the small intestine was so strong that we could not separate it without damaging the small intestine. We consequently performed a partial resection of the small intestine. Conclusion: Gauzeoma should be considered if a tumor presents a low signal intensity in both T1- and T2-weighted magnetic resonance images in patients with a history of abdominal surgery.