腹腔鏡下子宮体癌根治術時に診断した高分化乳頭状中皮腫の1例

抄録

  Well differentiated papillary mesothelioma, WDPM is a benign rare tumor. The longterm prognosis and characteristics of the disease are still unclear. We report a case of unifocal WDPM, two-millimeter in the greatest dimension, which was incidentally found in the small bowel mesentery during laparoscopic surgery for endometrial cancer. The patient is a woman in her 40s with no history of pregnancy. She was on hemodialysis for chronic renal failure due to type 2 diabetes and was consulted for anemia due to menorrhagia. Endometrioid carcinoma grade1 of uterine endometria was diagnosed by performing a total endometrial scraping. There was no tumor found in endometrium lesion on MRI study, and CT showed negative lymphadenopathy and distant metastasis. Laparoscopic hysterectomy and bilateral salpingo-oophorectomy were performe d. During operation, a small tumor was found on the small bowel mesentery during observation after hysterectomy and it was completely resected. Careful observation around the tumor was performed and no other tumors were found. The postoperative pathological diagnosis was endometrial carcinoma clinical stage IA, and WDPM for a small tumor on bowel. The patient is being followed up without any post treatment, and both endometrial cancer and WDPM have passed without recurrence. Complete resection of tumor, judicious sampling and immunohistochemistry, and careful histopathological diagnosis is necessary for WDPM. When mesentery tumor is accidentally found during laparoscopic surgery for gynecological diseases, careful resection would help us to detect small tumors such as WDPM.