腹腔鏡下で再発腫瘤切除を行った腹膜偽粘液腫の1例

抄録

  We report a case of recurrent pseudomyxoma peritonei that was removed by laparoscopic surgery. A 61-year old woman complained of abdominal fullness. Computed tomography (CT) showed a giant tumor occupying the whole abdominal cavity with massive ascites. Pseudomyxoma was suspected based on aspiration of gelatinous ascites. The results of aspiration cytology also indicated pseudomyxoma peritonei. Cytoreductive surgery (total abdominal hysterectomy + bilateral salpingo-oophorectomy + appendectomy + omentectomy + perinatology) was performed. Pathological examination showed that the tumor was derived from the right ovary. The appendix was intact. After primary surgery, monthly intraperitoneal chemotherapy with cisplatin (CDDP) was performed four times. However, tumor recurrence occurred in the pouch of Douglas 2 months after final intraperitoneal chemotherapy. This recurrent tumor measured 5 cm. There were no other recurrent tumors than that in the pouch of Douglas. Laparoscopic resection was deemed suitable for this localized and isolated recurrent tumor. We then resected the tumor by laparoscopic surgery. CDDP was administered as intraperitoneal chemotherapy at the end of this laparoscopic operation. After the laparoscopic operation with CDDP infusion, there has been no recurrence until the present. This report suggests that laparoscopic resection is useful for localized recurrence with low-grade malignancy as in this case.